Effects of ABVD chemotherapy on ovarian function: epidemiology, hormonal dosages and ultrasound morphologic analyses in 270 patients with Hodgkin’s disease
IntroductionClassical Hodgkin Lymphoma (HL) is a lymphoproliferative disease typically diagnosed in the young. The excellent results obtained with current treatment lead to long survival with age-related complications affecting patients’ survival and quality of life. One issue affecting HL patients...
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2023.1059393/full |
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| author | Mariavita Ciccarone Mariavita Ciccarone Paola Cavaceppi Paola Cavaceppi Cristiano Tesei Stefania Brunetti Alessandro Pulsoni Ombretta Annibali Cristiano Gasparoli Roberta Battistini Stefan Hohaus Sabrina Pelliccia Agostino Tafuri Maria Christina Cox Maria Cantonetti Luigi Rigacci Elisabetta Abruzzese |
| author_facet | Mariavita Ciccarone Mariavita Ciccarone Paola Cavaceppi Paola Cavaceppi Cristiano Tesei Stefania Brunetti Alessandro Pulsoni Ombretta Annibali Cristiano Gasparoli Roberta Battistini Stefan Hohaus Sabrina Pelliccia Agostino Tafuri Maria Christina Cox Maria Cantonetti Luigi Rigacci Elisabetta Abruzzese |
| author_sort | Mariavita Ciccarone |
| collection | DOAJ |
| description | IntroductionClassical Hodgkin Lymphoma (HL) is a lymphoproliferative disease typically diagnosed in the young. The excellent results obtained with current treatment lead to long survival with age-related complications affecting patients’ survival and quality of life. One issue affecting HL patients is infertility. This problem can be easily overcome in males with seminal liquid cryopreservation, however, in females it is more complex either in terms of the quality of the cryopreserved material or the patients’ age at diagnosis. Moreover, not all chemo- or radio-therapies have the same negative impact on fertility.The main objectives of this study was to collect epidemiological information on HL patients involved in fertility preservation counseling and to analyze the impact of ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine), the standard treatment for HL, on ovarian function, hormonal levels and ovarian and uterine tissue morphologies. Patterns of fertility preservation were also reported.MethodsData were obtained from 270 female patients at HL onset who were interested in fertility counseling prior to therapy initiation. Each patient was assessed at HL diagnosis for levels of Anti-Mullerian Hormone (AMH), Follicle Stimulating Hormone (FSH), and 17β-oestradiol (17β-oe), with additional assessments at 6 and 12 months after chemotherapy. Patients were evaluated with ultrasound scans to study the number of ovarian follicles and the degree of uterine thickness at the same timepoints.ResultsThe average patient AMH level showed a statistically significant reduction at 6 months after chemotherapy (p=0.05) and by the 12 month time point returned to near pre-chemotherapy values. FSH and 17β-oe levels did not significantly vary throughout the study period. ABVD chemotherapy was associated with a significant reduction of both ovarian follicles and endometrial thickness at the 6 month time point followed by a recovery at the 12 time point in both ovaries. Different results were observed when patients changed treatment to a more intensive one.DiscussionBased on the results from the hormonal measurements and the follicle echography, it appears that the toxic effect of ABVD on fertility is transient, whereas, in contrast, more intensive therapies may potentially be more harmful and long-lasting. |
| first_indexed | 2024-04-09T17:02:36Z |
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| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-09T17:02:36Z |
| publishDate | 2023-04-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-f720c0a8f0024b1986758cfc364e8ca52023-04-21T04:31:03ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2023-04-011310.3389/fonc.2023.10593931059393Effects of ABVD chemotherapy on ovarian function: epidemiology, hormonal dosages and ultrasound morphologic analyses in 270 patients with Hodgkin’s diseaseMariavita Ciccarone0Mariavita Ciccarone1Paola Cavaceppi2Paola Cavaceppi3Cristiano Tesei4Stefania Brunetti5Alessandro Pulsoni6Ombretta Annibali7Cristiano Gasparoli8Roberta Battistini9Stefan Hohaus10Sabrina Pelliccia11Agostino Tafuri12Maria Christina Cox13Maria Cantonetti14Luigi Rigacci15Elisabetta Abruzzese16Associazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, ItalyGynecologic Unit , San Carlo di Nancy Hospital, Rome, ItalyAssociazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, ItalyLabAurelia, Rome, ItalyAssociazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, ItalyAssociazione Gemme Dormienti Organizzazione Non Lucrativa di Utilità Sociale (ONLUS), Rome, ItalyDepartment of Cellular Biotechnology and Haematology, Sapienza University, Rome, ItalyUOC Haematology Stem Cell Transplantation, University Campus Bio Medico, Rome, ItalyLaboratory Medicine, San Carlo di Nancy Hospital, Rome, ItalyUOC Ematologia e Trapianti CSE, Azienda Ospedaliera (AO) San Camillo Forlanini, Rome, ItalyPoliclinico Gemelli Foundation, Catholic University of the Sacred Heart, Rome, ItalyHaematology Unit, Azienda Ospedaliera‐ Universitaria Sant’Andrea, Rome, ItalyHaematology Unit, Azienda Ospedaliera‐ Universitaria Sant’Andrea, Rome, Italy0Hematology, Tor Vergata University Hospital, Rome, Italy0Hematology, Tor Vergata University Hospital, Rome, ItalyUOC Ematologia e Trapianti CSE, Azienda Ospedaliera (AO) San Camillo Forlanini, Rome, Italy1Hematology, S. Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, ItalyIntroductionClassical Hodgkin Lymphoma (HL) is a lymphoproliferative disease typically diagnosed in the young. The excellent results obtained with current treatment lead to long survival with age-related complications affecting patients’ survival and quality of life. One issue affecting HL patients is infertility. This problem can be easily overcome in males with seminal liquid cryopreservation, however, in females it is more complex either in terms of the quality of the cryopreserved material or the patients’ age at diagnosis. Moreover, not all chemo- or radio-therapies have the same negative impact on fertility.The main objectives of this study was to collect epidemiological information on HL patients involved in fertility preservation counseling and to analyze the impact of ABVD (adriamycin, bleomycin, vinblastine, and dacarbazine), the standard treatment for HL, on ovarian function, hormonal levels and ovarian and uterine tissue morphologies. Patterns of fertility preservation were also reported.MethodsData were obtained from 270 female patients at HL onset who were interested in fertility counseling prior to therapy initiation. Each patient was assessed at HL diagnosis for levels of Anti-Mullerian Hormone (AMH), Follicle Stimulating Hormone (FSH), and 17β-oestradiol (17β-oe), with additional assessments at 6 and 12 months after chemotherapy. Patients were evaluated with ultrasound scans to study the number of ovarian follicles and the degree of uterine thickness at the same timepoints.ResultsThe average patient AMH level showed a statistically significant reduction at 6 months after chemotherapy (p=0.05) and by the 12 month time point returned to near pre-chemotherapy values. FSH and 17β-oe levels did not significantly vary throughout the study period. ABVD chemotherapy was associated with a significant reduction of both ovarian follicles and endometrial thickness at the 6 month time point followed by a recovery at the 12 time point in both ovaries. Different results were observed when patients changed treatment to a more intensive one.DiscussionBased on the results from the hormonal measurements and the follicle echography, it appears that the toxic effect of ABVD on fertility is transient, whereas, in contrast, more intensive therapies may potentially be more harmful and long-lasting.https://www.frontiersin.org/articles/10.3389/fonc.2023.1059393/fullfertility preservationHodgkin’s lymphomaovarian failureAnti-Mullerian hormoneearly menopause |
| spellingShingle | Mariavita Ciccarone Mariavita Ciccarone Paola Cavaceppi Paola Cavaceppi Cristiano Tesei Stefania Brunetti Alessandro Pulsoni Ombretta Annibali Cristiano Gasparoli Roberta Battistini Stefan Hohaus Sabrina Pelliccia Agostino Tafuri Maria Christina Cox Maria Cantonetti Luigi Rigacci Elisabetta Abruzzese Effects of ABVD chemotherapy on ovarian function: epidemiology, hormonal dosages and ultrasound morphologic analyses in 270 patients with Hodgkin’s disease Frontiers in Oncology fertility preservation Hodgkin’s lymphoma ovarian failure Anti-Mullerian hormone early menopause |
| title | Effects of ABVD chemotherapy on ovarian function: epidemiology, hormonal dosages and ultrasound morphologic analyses in 270 patients with Hodgkin’s disease |
| title_full | Effects of ABVD chemotherapy on ovarian function: epidemiology, hormonal dosages and ultrasound morphologic analyses in 270 patients with Hodgkin’s disease |
| title_fullStr | Effects of ABVD chemotherapy on ovarian function: epidemiology, hormonal dosages and ultrasound morphologic analyses in 270 patients with Hodgkin’s disease |
| title_full_unstemmed | Effects of ABVD chemotherapy on ovarian function: epidemiology, hormonal dosages and ultrasound morphologic analyses in 270 patients with Hodgkin’s disease |
| title_short | Effects of ABVD chemotherapy on ovarian function: epidemiology, hormonal dosages and ultrasound morphologic analyses in 270 patients with Hodgkin’s disease |
| title_sort | effects of abvd chemotherapy on ovarian function epidemiology hormonal dosages and ultrasound morphologic analyses in 270 patients with hodgkin s disease |
| topic | fertility preservation Hodgkin’s lymphoma ovarian failure Anti-Mullerian hormone early menopause |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2023.1059393/full |
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