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Ovarian Failure Risk Differs with Chemo Type in Hodgkin's

Significant risk from alkylating chemo; little risk from nonalkylating for those less than age 32

MONDAY, Dec. 19 (HealthDay News) -- For female survivors of Hodgkin's lymphoma, treatment with nonalkylating chemotherapy carries little risk of premature ovarian failure (POF) for those younger than 32 years, whereas alkylating chemotherapy carries a substantially increased risk of POF, according to a study published online Dec. 19 in the Journal of Clinical Oncology.

Marleen A.E. van der Kaaij, M.D., from the University of Groningen in the Netherlands, and colleagues investigated the effect of treatment regimens on the occurrence of POF and motherhood in 406 female survivors of Hodgkin's lymphoma, aged 14 to 40 years, not currently using hormonal contraceptives. The cumulative risk of POF was estimated, and predictive factors were evaluated at a median follow-up of 16 years.

The investigators found that the cumulative POF risk was 60 and 3 percent after alkylating and nonalkylating chemotherapy, respectively. There was a linear dose relationship between alkylating chemotherapy and POF occurrence. There was an increase in the POF risk by 23 percent per year of age at treatment. The cumulative POF risks were 3 and 9 percent for women treated without alkylating chemotherapy at age younger than 32 years and 32 years or older, respectively. The cumulative POF risk was independent of age at treatment, if menstruation resumed after treatment. Of the women without POF, 41 percent had one or more children after treatment, compared with 22 percent of women with POF.

"Women treated with nonalkylating chemotherapy younger than 32 years of age have little to no excess POF risk. Alkylating chemotherapy carries a serious POF risk, with HRs of 10 to 21, depending on [the] dose administered," the authors write.

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