Female fertility following dose-adjusted EPOCH-R chemotherapy in primary mediastinal B-cell lymphomas

Abstract

We assessed fertility/gonadal function in premenopausal women treated with dose-adjusted EPOCH-Rituximab for untreated primary mediastinal B-cell lymphoma (PMBL). Eligible patents were ≤ 50 years and premenopausal. Serial reproductive histories were obtained and hormonal assays were performed on serum samples before, at the end of treatment and 4–18 months later. Twenty-eight eligible women had a median age (range) of 31 (21–50) years and were followed a median of 7.3 years. Of 23 patients who completed a questionnaire, 19 (83%) were and four were not menstruating prior to chemotherapy. Amenorrhea developed in 12 patients during chemotherapy. At > 1-year follow-up, 14/19 (74%) patients were menstruating, all < 35 years old, and six (43%) of these patients delivered healthy children. Hormonal assays showed ovarian dysfunction during chemotherapy in all patients with varying recovery at 4–18 months after treatment. Fertility was preserved in most women with ovarian failure confined to patients > 40 years old.

Keywords:

• Aggressive B-cell lymphoma
• DA-EPOCH-R
• fertility following chemotherapy
• fertility
• primary mediastinal B-cell lymphoma

Acknowledgements

The authors thank James Gulley for his contributions to this study.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article at http://dx.doi.org/10.3109/10428194.2015.1118476