Background. BEACOPP escalated includes alkylating agents and its gonadal toxicity has been reported in prospective and retrospective studies. This retrospective study analyzed fertility of 98 female patients (pts) with initial diagnosis of Hodgkin lymphoma (HL) in advanced stages treated with BEACOPP escalated.
Patients and Methods. Overall 98 women aged 18 – 34 years (median age at diagnosis was 27 years) were treated with BEACOPP escalated between 1997 and 2015: 8 cycles received 57 pts (58%), 6 cycles 39 pts (40%) and 4 cycles 2 pts (2%). Additional radiotherapy was indicated in 33 pts (32%). Forty nine pts (48%) received GnRH analogue (Diphereline) during chemotherapy to preserve their ovarian function. Median follow-up after the end of treatment was 144 months (range, 57 – 210).
Results. Overall 26 women delivered 33 babies including 7(27%) women with 2 deliveries. Median age at diagnosis HL was 24 years (range, 19 – 32). Number of all delivered healthy babies was 32 and only one baby was born with small cleft lip. All pregnancies were spontaneous except of 2 women that undewent in vitro fertilization . Another 5 female pts are still pregnant. Median time from the end of chemotherapy until the delivery of the first baby was 78 months (range, 21 – 169). Two pregnancies were terminated prematurely (week 20 and 22) due to congenital malformations: monosomy 45,X0 Turner syndrome and serious cleft lip. Despite the low number of pts and a relatively short-term follow-up we assume, that we can expect a higher rate of pregnancies and deliveries after the reduction from 8 to 6 cycles of BEACOPP escalated.
Conclusion. New strategies for the protection of fertility should be offered to young female HL patients treated with BEACOPP escalated therapy. Reduced number of cycles of BEACOPP escalated may further contribute to preservation of their fertility.