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Annals of Oncology Advance Access first published online on June 9, 2008
This version published online on June 17, 2008
Annals of Oncology, doi:10.1093/annonc/mdn376
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© The Author 2008. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Assessment of male fertility in patients with Hodgkin's lymphoma treated in the German Hodgkin Study Group (GHSG) clinical trials

M. Sieniawski1,2,*, T. Reineke2, A. Josting1,2, L. Nogova1,2, K. Behringer1,2, T. Halbsguth1,2, M. Fuchs1,2, V. Diehl2 and A. Engert1,2

1 Department of Internal Medicine, University Hospital Cologne, Cologne, Germany
2 German Hodgkin Study Group, University Hospital Cologne, Cologne, Germany

* Correspondence to: Dr M. Sieniawski, Department of Internal Medicine, University Hospital Cologne, Kerpener Strasse 62, 50937 Cologne, Germany. Tel: +49-221-4785933; Fax: +49-221-4783778; E-mail: michal.sieniawski{at}ncl.ac.uk

Background: Infertility is one of the most significant side-effects in long-term survivors of successfully treated Hodgkin's lymphoma (HL).

Patients and methods: The fertility status was assessed in male HL patients enrolled into trials of the German Hodgkin Study Group from 1988 to 2003.

Results: In pre-treatment analysis (n = 202), 20% of patients had normozoospermia, 11% azoospermia and 69% had other dyspermia. In post-treatment analysis (n = 112), 64% of patients had azoospermia, 30% other dyspermia and 6% normozoospermia (P < 0.001). Azoospermia was observed in 90% of patients treated with chemotherapy alone, 67% of those treated with combined modality and 11% of those treated with radiotherapy alone (P < 0.001). Azoospermia was more frequent after 4x cyclophosphamide, vincristine, procarbazine, prednisone, doxorubicin, bleomycin, vinblastine, dacarbazine (COPP/ABVD) (91%), 8x bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, prednisone (BEACOPP) baseline (93%) and 8x BEACOPP escalated (87%) compared with 2x COPP/ABVD (56%; P = 0.003). There was a statistically significant difference in post-treatment follicle-stimulating hormone (FSH) levels between patients with azoospermia and those with preserved spermatogenesis (P = 0.001).

Conclusions: Depending on the treatment received, male HL patients are at high risk of infertility after treatment. FSH might be used as surrogate parameter for male fertility in future studies.

chemotherapy, follicle-stimulating hormone, Hodgkin's lymphoma, male fertility

The seventh author's affiliation details have been corrected.

Received for publication April 29, 2008. Accepted for publication May 2, 2008.


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