Faculty Opinions recommendation of Gonadal Function Recovery in Patients With Advanced Hodgkin Lymphoma Treated With a PET-Adapted Regimen: Prospective Analysis of a Randomized Phase III Trial (AHL2011).

2021 ◽  
Author(s):  
Eva Chalas
Keyword(s):  
Hodgkin Lymphoma ◽  
Phase Iii ◽  
Prospective Analysis ◽  
Gonadal Function ◽  
Phase Iii Trial ◽  
Function Recovery

scholarly journals Randomized Phase III Trial of ABVD Versus Stanford V With or Without Radiation Therapy in Locally Extensive and Advanced-Stage Hodgkin Lymphoma: An Intergroup Study Coordinated by the Eastern Cooperative Oncology Group (E2496)

2013 ◽  
Vol 31 (6) ◽  
pp. 684-691 ◽  
Author(s):  
Leo I. Gordon ◽  
Fangxin Hong ◽  
Richard I. Fisher ◽  
Nancy L. Bartlett ◽  
Joseph M. Connors ◽  
...  
Keyword(s):  
Complete Remission ◽  
Hodgkin Lymphoma ◽  
Eastern Cooperative Oncology Group ◽  
Standard Of Care ◽  
Phase Iii ◽  
Random Assignment ◽  
Oncology Group ◽  
Phase Iii Trial ◽  
Free Survival ◽  
End Point

Purpose Although ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) has been established as the standard of care in patients with advanced Hodgkin lymphoma, newer regimens have been investigated, which have appeared superior in early phase II studies. Our aim was to determine if failure-free survival was superior in patients treated with the Stanford V regimen compared with ABVD. Patients and Methods The Eastern Cooperative Oncology Group, along with the Cancer and Leukemia Group B, the Southwest Oncology Group, and the Canadian NCIC Clinical Trials Group, conducted this randomized phase III trial in patients with advanced Hodgkin lymphoma. Stratification factors included extent of disease (localized v extensive) and International Prognostic Factors Project Score (0 to 2 v 3 to 7). The primary end point was failure-free survival (FFS), defined as the time from random assignment to progression, relapse, or death, whichever occurred first. Overall survival, a secondary end point, was measured from random assignment to death as a result of any cause. This design provided 87% power to detect a 33% reduction in FFS hazard rate, or a difference in 5-year FFS of 64% versus 74% at two-sided .05 significance level. Results There was no significant difference in the overall response rate between the two arms, with complete remission and clinical complete remission rates of 73% for ABVD and 69% for Stanford V. At a median follow-up of 6.4 years, there was no difference in FFS: 74% for ABVD and 71% for Stanford V at 5 years (P = .32). Conclusion ABVD remains the standard of care for patients with advanced Hodgkin lymphoma.

Gonadal Function Recovery in Patients With Advanced Hodgkin Lymphoma Treated With a PET-Adapted Regimen: Prospective Analysis of a Randomized Phase III Trial (AHL2011)

2021 ◽  
pp. JCO.21.00068
Author(s):  
Isabelle Demeestere ◽  
Judith Racape ◽  
Julie Dechene ◽  
Jehan Dupuis ◽  
Franck Morschhauser ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Ovarian Reserve ◽  
Ovarian Function ◽  
Semen Analysis ◽  
Alkylating Agents ◽  
Phase Iii ◽  
Gonadal Function ◽  
Gonadal Dysfunction ◽  
Positron Emission ◽  
End Of Treatment

PURPOSE The prospective, randomized AHL2011 trial demonstrated that the use of the doxorubicin, bleomycin, vinblastine, and dacarbazine regimen (ABVD) after two cycles of bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPPescalated) in early responders on the basis of a positron emission tomography (PET)–driven strategy was safe and minimized toxicity compared with standard 6 BEACOPPescalated cycles. This substudy investigated the benefit of this strategy in gonadal function and fertility in patients under 45 years old. METHODS Ovarian function was assessed by serum measurement of follicle-stimulating hormone (FSH), estradiol, and anti-müllerian hormone in women, and semen analysis, FSH, and testosterone levels were used to evaluate testicular function in men at baseline, end of treatment, and during 5 years of follow-up. RESULTS A total of 145 women and 424 men, enrolled between May 19, 2011, and April 29, 2014, were included. The risk of premature ovarian insufficiency (FSH > 24 IU/L) and of having a low ovarian reserve (anti-müllerian hormone < 0.5 ng/mL) was reduced after treatment in the PET-driven group (odds ratio [OR], 0.20; 95% CI, 0.08 to 0.50; P = .001 and OR, 0.15; 95% CI, 0.04 to 0.56, P = .005, respectively). Both parameters were correlated with age and dose of alkylating agents. However, no significant differences were observed in terms of pregnancy rates. Men in the PET-driven group had a higher recovery rate of sperm parameters after treatment compared with the standard BEACOPPescalated group, as well as a lower risk of severe testicular damage (OR, 0.26; 95% CI, 0.13 to 0.5; P < .0001) and a higher likelihood of achieving pregnancy (OR, 3.7; 95% CI, 1.4 to 9.3; P = .004). CONCLUSION Although both treatments affected ovarian reserve and spermatogenesis, the PET-driven strategy decreased the risk of gonadal dysfunction and infertility in advanced Hodgkin lymphoma.

Reduced dose radiotherapy for local control in non-Hodgkin lymphoma: A randomised phase III trial

2011 ◽  
Vol 100 (1) ◽  
pp. 86-92 ◽  
Author(s):  
Lisa Lowry ◽  
Paul Smith ◽  
Wendi Qian ◽  
Stephen Falk ◽  
Kim Benstead ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Local Control ◽  
Phase Iii ◽  
Phase Iii Trial ◽  
Reduced Dose ◽  
Non Hodgkin Lymphoma

scholarly journals Gonadal Function Recovery and Fertility in Women Treated with Chemo- and/or Radiotherapy for Hodgkin’s and Non-Hodgkin Lymphoma

Chemotherapy ◽  
2019 ◽  
Vol 64 (1) ◽  
pp. 36-41 ◽  
Author(s):  
Guido Gini ◽  
Ombretta Annibali ◽  
Diana Lupasco ◽  
Caterina Bocci ◽  
Valeria Tomarchio ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Univariate Analysis ◽  
Prevalence Ratio ◽  
Reproductive Age ◽  
Gonadal Function ◽  
Gnrh Analogues ◽  
Chemotherapeutic Regimen ◽  
Non Hodgkin Lymphoma ◽  
Function Recovery

Background: Fertility and gonadal function represent one of the most important aspects for long-term lymphoma survivors. Aims: The aim of our study was to determine possible risk factors, such as age at treatment, chemotherapeutic regimen, protection with oral contraceptives (OCs), and gonadotropin-releasing hormone (GnRH) analogues in female patients treated for Hodgkin’s lymphoma (HL) or non-Hodgkin lymphoma (NHL) at a reproductive age. Methods: Patients between the age of 16 and 50 years at the time of HL or NHL diagnosis were selected. Eligible patients were requested to respond to a questionnaire by phone interview about fertility, menstrual status, sexual aspects, and treatment with OCs or GnRH analogues during chemotherapy. Results: The resumption of menstrual activity was associated with the use of the OCs and GnRH analogues during chemotherapy (p = 0.008 and 0.034, respectively). At univariate analysis, the use of OCs during chemotherapy was associated with a lower risk of amenorrhea (prevalence ratio [PR] = 0.37; 95% CI 0.17–0.82). A higher age at the time of treatment correlated positively with therapy-induced amenorrhea, with a difference of 12.8 years between the mean age at diagnosis of the women with therapy-induced amenorrhea and those who resumed their menses. Amenorrhea was significantly higher in women receiving R-CHOP than in women treated with ABVD (PR = 6.00; 95% CI 2.32–15.54). Moreover, NHL had an infertility PR of 1.51 (95% CI 0.86–2.45) at multivariate analysis compared to HL. Conclusions: This study suggests a possible role of pharmacological prophylaxis with OCs and GnRH analogues.

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