Good Prognosis for Parenthood for Women Treated for Hodgkin Lymphoma During Childhood or Adolescence


Key Points

  • Only for the age group of 40 to 44 years was parenthood less likely for survivors.
  • Parenthood was less likely in patients receiving pelvic vs abdominal and supradiaphragmatic radiation.

In a German study reported in The Lancet Oncology, Brämswig et al found that women treated for Hodgkin lymphoma during childhood or adolescence had a good prognosis for achieving parenthood.

Study Details

This prospective longitudinal study included 467 female patients aged < 18 years at diagnosis who participated in five Hodgkin’s lymphoma treatment studies between June 1978 and July 1995. Women included in the cohort had been followed for ≥ 5 years, were in continuous complete remission, and had no second malignancy or Hodgkin lymphoma relapse before parenthood. Parenthood was defined as delivery of a live born child. Frequency of parenthood was compared with that in the German female population aged 16 to 49 years, using data from the 2012 Mikrozensus population survey.

Parenthood Rates

Patients had a median follow-up of 20.4 years. In total, 228 (49%) women had 406 children (median of 1.78 children per mother). The cumulative incidence of parenthood was 67% at 27.7 years of follow-up (ie, the longest period until a patient had her first child) and 69% at 39.8 years of age (ie, the oldest age at which a patient had her first child). The proportion of women who were mothers did not differ between patients and the general population for age groups 16 to 19, 20 to 24, 25 to 29, 30 to 34, 35 to 39, or 45 to 49 years. Patients had a significantly lower rate of parenthood in the 40 to 44 year group (61% vs 78%, P = .001).

Effect of Treatments

No or minor effects on likelihood of motherhood were associated with procarbazine in cumulative doses up to 11,400 mg/m², cyclophosphamide in cumulative doses up to 6,000 mg/m², alkylating agent dose scores of 1 to 5, therapy group based on disease stage at diagnosis, abdominal and supradiaphragmatic radiation, or age at treatment. Parenthood rate was significantly reduced in patients receiving pelvic vs abdominal and supradiaphragmatic radiation (hazard ratio = 0.76, P = .01).

The investigators concluded: “The results of this study document an overall favourable prognosis for parenthood in female survivors of Hodgkin’s lymphoma. They will assist counselling of female survivors about their positive potential for future parenthood.”

Jurgen H. Brämswig, MD, of University Children’s Hospital, Albert-Schweitzer-Campus 1,  Münster, is the corresponding author for the Lancet Oncology article.

The study was funded by Deutsche Kinderkrebsstiftung, Jens-Brunken-Stiftung für Leukämie und Lymphomforschung, and Kinderkrebshilfe Münster. The study authors reported no potential conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.