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Annals of Oncology Advance Access originally published online on July 10, 2006
Annals of Oncology 2006 17(9):1428-1433; doi:10.1093/annonc/mdl149
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© 2006 European Society for Medical Oncology

hematologic malignancies

Treatment-related premature ovarian failure as a long-term complication after Hodgkin's lymphoma

UKH Haukvik1, I Dieset1, T Bjøro2,*, H Holte3 and SD Fosså4

1 University of Oslo, Norway
2 Central Laboratory Oslo, Norway
3 Department of Medical Oncology Oslo, Norway
4 Department of Clinical Cancer Research, Rikshospitalet-Radiumhospitalet Medical Center, Oslo, Norway

*Correspondence to: Dr T. Bjøro, Central Laboratory, Rikshospitalet-Radiumhopitalet Trust, Montebello, N-0310 Oslo, Norway. Tel: +47 229 35906; Fax: +47 229 34047; E-mail: trine.bjoro{at}ioks.uio.no

Background: One of the medical sequelae that chemo- and radiotherapy may cause is premature ovarian failure (POF). The scope of this study was to investigate the risk of developing POF as a long-term complication in young women treated for Hodgkin's lymphoma.

Patients and methods: The 99 women included in the study were treated between 1975 and 1992 at the Norwegian Radium Hospital. All patients received radiotherapy and 67 of the women also received chemotherapy.

Results: POF was found in 37.4% of the patients. The risk of developing POF was significantly higher if the patient received chemotherapy in addition to radiotherapy. Furthermore, the risk increased if chemotherapy included alkylating agents. Long-term follow-up revealed that women who at the time of treatment were under 30 years of age developed POF later, but with the same cumulative risk as women above 30 years of age.

Conclusions: The risk of developing POF after radio- and chemotherapy is higher than earlier estimates suggest. After an observation time of 15 years the cumulative risk is 38% independent of age at the time of treatment. Age below 30 years at the time of treatment delays the development of POF, but does not decrease the life-time risk.

Key words: chemotherapy, oestrogen deficiency, Hodgkin's lymphoma, long-term sequelae, premature ovarian failure, radiotherapy


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