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Dmitrieva I, Nazarenko T, Polushkina E, Khokhlova S, Shpirko V, Tumyan G, Martirosyan Y, Sukhih G. P-665 Fertility in female patients treated for Hodgkin’s lymphoma. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Study question
we aimed to determine factors which could possibly predict future ability to conceive in patients that are to be treated for Hodgkin's lymphoma.
Summary answer
we identified the key characteristics for high probability to achieve a spontaneous pregnancy: younger age, high ovarian reserve and GnrH-a or COC during chemotherapy.
What is known already
Hodgkin's lymphoma is considered one of the most aggressive yet successfully treatable oncological diseases. Prevalence among younger patients and highly gonadotoxic chemotherapy regimens bring up a question of fertility preservation. The issue of predicting the future fertility potential of patients who will have undergone chemotherapy treatment is unresolved to this day. Determining the influence of different factors would allow the creation of personalized fertility preservation treatment plans for each patient.
Study design, size, duration
This observational study was conducted at the V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology. It included 149 patients of reproductive age diagnosed with Hodgkin's lymphoma who had indications to chemotherapy. All of the patients signed an informed consent form prior to participation.
Participants/materials, setting, methods
The study included 149 participants with a mean age of 23 ± 6.08 years. All of the participants underwent chemotherapy either without (68.09%) or with ovarian protection (OP) (31.91%). The prevalent chemotherapeutic agents were Adriamycin, Oncovin and Bleomycin. The median number of cycles was 6 ± 2.62.
Main results and the role of chance
Out of all patients 18 had a recurrence and only one died. One patient had three recurrences but after treatment she resumed her menstrual function, achieved one spontaneous pregnancy and live birth. This patient was only 21 years old with very high antral follicular count and had a very short period between recurrences, that way her treatment was performed with continuous GnRH-a protection. Out of patients without OP, 44.8% lost their menstrual function and later had to undergo assisted reproduction treatment, including oocyte donation. Menstrual function recovery rate was higher in both groups with GnRH-a and COC - 80% and 84%, respectively – but not high enough to be statistically significant. Time to recovery was 2 ± 2.57 months, with no significant difference between groups with COC, GnRH-a or without any protection. Patients aged 30 and older had a lower menstruation recovery rate (33.33%) compared to 71.08% and 75% for those younger than 30 and 20, respectively. Two more patients were prepubescent and therefore were not included in the statistical analysis but showed normal regular menses after menarche and achieved spontaneous pregnancies.
Limitations, reasons for caution
Despite aforementioned results the quantity of factors does not let us draw compelling conclusions about their degree of influence; this way multifactorial analysis with more participants would be more preferable. A higher rate of pregnancies in OP group could also correlate with higher alertness and therefore earlier attempts to conceive.
Wider implications of the findings
our findings demonstrate the need for and possibility of predictive model development. This would provide an opportunity not only to establish fertility preservation treatment options but also help in reproductive planning for those who have completed their main treatment, taking the risk of POI into consideration.
Trial registration number
not applicable
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Affiliation(s)
- I Dmitrieva
- National Medical Research Center for Obstetrics- Gynecology and Perinatology named after V.I. Kulakov, Research and clinical department for assisted reproductive technologies named after F. Paulsen , Moscow, Russia C.I.S
| | - T Nazarenko
- National Medical Research Center for Obstetrics- Gynecology and Perinatology named after V.I. Kulakov, Research and clinical department for assisted reproductive technologies named after F. Paulsen , Moscow, Russia C.I.S
| | - E Polushkina
- National Medical Research Center for Obstetrics- Gynecology and Perinatology named after V.I. Kulakov , 2nd Maternity ward, Moscow, Russia C.I.S
| | - S Khokhlova
- National Medical Research Center for Obstetrics- Gynecology and Perinatology named after V.I. Kulakov, Oncology Department of Antitumor Chemotherapy , Moscow, Russia C.I.S
| | - V Shpirko
- N.N. Blokhin National Medical Research Center of Oncology, Department of Hemoblastosis Chemotherapy , Moscow, Russia C.I.S
| | - G Tumyan
- N.N. Blokhin National Medical Research Center of Oncology, Department of Hemoblastosis Chemotherapy , Moscow, Russia C.I.S
| | - Y Martirosyan
- National Medical Research Center for Obstetrics- Gynecology and Perinatology named after V.I. Kulakov, Research and clinical department for assisted reproductive technologies named after F. Paulsen , Moscow, Russia C.I.S
| | - G Sukhih
- National Medical Research Center for Obstetrics- Gynecology and Perinatology named after V.I. Kulakov, Research and clinical department for assisted reproductive technologies named after F. Paulsen , Moscow, Russia C.I.S
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Tumyan G, Kichigina M, Paramonova E, Medvedovskaya E, Trofimova O, Ryabuhina Y, Demina E, Zeynalova P, Kolomeytsev O. UPDATED SAFETY AND EFFICACY RESULTS OF «HLMoscow 1-3» STUDY FOR THE 147 UNTREATED PATIENTS WITH ADVANCED CLASSICAL HODGKIN LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.169_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- G. Tumyan
- Hematology; N.N. Blokhin National Cancer Research Center; Moscow Russian Federation
| | - M. Kichigina
- Hematology; N.N. Blokhin National Cancer Research Center; Moscow Russian Federation
| | - E. Paramonova
- Hematology; N.N. Blokhin National Cancer Research Center; Moscow Russian Federation
| | - E. Medvedovskaya
- Hematology; N.N. Blokhin National Cancer Research Center; Moscow Russian Federation
| | - O. Trofimova
- Hematology; N.N. Blokhin National Cancer Research Center; Moscow Russian Federation
| | - Y. Ryabuhina
- Hematology; N.N. Blokhin National Cancer Research Center; Moscow Russian Federation
| | - E. Demina
- Hematology; National Medical and Surgical Center named after N.I. Pirogov; Moscow Moscow Russian Federation
| | - P. Zeynalova
- Hematology; N.N. Blokhin National Cancer Research Center; Moscow Russian Federation
| | - O. Kolomeytsev
- Hematology; N.N. Blokhin National Cancer Research Center; Moscow Russian Federation
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Lepkov S, Tumyan G, Kolomiytcev O, Ribykhina J, Zeynalova P, Kokosadze N, Kluchagina J, Kuprishina N, Ivanova V, Lazarev I, Zacharov O, Borisovskaya S, Ivashenco R, Subortceva I, Ettinger O, Nikitin I. IMPACT OF DIFFERENT TYPES OF ANTIVIRAL THERAPY ON PROGNOSIS OF HEPATITIS C VIRUS POSITIVE MARGINAL ZONE LYMPHOMAS. Hematol Oncol 2019. [DOI: 10.1002/hon.130_2631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- S. Lepkov
- Hospital Therapy; N.I. Pirogov Russian National Research Medical University; Moscow Russian Federation
| | - G. Tumyan
- Hematology and Bone Marrow Transplantation; N. N. Blokhin National Medical Research Centre of oncology; Moscow Russian Federation
| | - O. Kolomiytcev
- Hematology and Bone Marrow Transplantation; N. N. Blokhin National Medical Research Centre of oncology; Moscow Russian Federation
| | - J. Ribykhina
- Hematology and Bone Marrow Transplantation; N. N. Blokhin National Medical Research Centre of oncology; Moscow Russian Federation
| | - P. Zeynalova
- Hematology and Bone Marrow Transplantation; N. N. Blokhin National Medical Research Centre of oncology; Moscow Russian Federation
| | - N. Kokosadze
- Hematology and Bone Marrow Transplantation; N. N. Blokhin National Medical Research Centre of oncology; Moscow Russian Federation
| | - J. Kluchagina
- Oncology; I.M. Sechenov First Moscow State Medical University (Sechenov University); Moscow Russian Federation
| | - N. Kuprishina
- Hematology and Bone Marrow Transplantation; N. N. Blokhin National Medical Research Centre of oncology; Moscow Russian Federation
| | - V. Ivanova
- Hematology; Moscow Сity Hematological Center by S.P. Botkin; Moscow Russian Federation
| | - I. Lazarev
- Hematology; Moscow Сity Hematological Center by S.P. Botkin; Moscow Russian Federation
| | - O. Zacharov
- Hematology; Moscow Сity Hematological Center by S.P. Botkin; Moscow Russian Federation
| | - S. Borisovskaya
- Hospital Therapy; Moscow Clinical City Hospital by V.M. Buyanov; Moscow Russian Federation
| | - R. Ivashenco
- Hospital Therapy; Moscow Clinical City Hospital by V.M. Buyanov; Moscow Russian Federation
| | - I. Subortceva
- Hematology; National Medical Research Center for Hematology; Moscow Russian Federation
| | - O. Ettinger
- Hospital Therapy; N.I. Pirogov Russian National Research Medical University; Moscow Russian Federation
| | - I. Nikitin
- Hospital Therapy; N.I. Pirogov Russian National Research Medical University; Moscow Russian Federation
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Cavalli F, Jin J, Pylypenko H, Verhoef G, Siritanaratkul N, Drach J, Raderer M, Mayer J, Pereira J, Tumyan G, Okamoto R, Nakahara S, Hu P, Appiani C, Nemat S, Robak T. Final overall survival results of frontline bortezomib plus rituximab, cyclophosphamide, doxorubicin, and prednisone (VR-CAP) vs R-CHOP in transplantation-ineligible patients (pts) with newly diagnosed mantle-cell lymphoma (MCL): A randomized, open-label, phase III (LYM-3002) study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Lepkov S, Subortceva I, Tumyan G, Zejnalova P, Kolomejtsev O, Ryabukhina Y, Semenova A, Kokosadze N, Kupryshina N, Komarov I, Malikhova O, Ettinger O, Borisovskaya S, Lazarev I, Ivanova V, Ivashhenko R, Kemizh Y, Alla Kovrigina A, Nikitin I, Urvanceva O. PRIMARY EXTRANODAL NON-HODGKIN'S LYMPHOMA OF THE LIVER (PLL). Hematol Oncol 2017. [DOI: 10.1002/hon.2439_134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- S. Lepkov
- Therapy; Russian National Research Medical University Named After N.I. Pirogov; Moscow Russian Federation
| | - I. Subortceva
- Hematology; Research Center For Haematology; Moscow Russian Federation
| | - G. Tumyan
- Oncology; National Research Center For Oncology Named After N.N. Blochin; Moscow Russian Federation
| | - P. Zejnalova
- Oncology; National Research Center For Oncology Named After N.N. Blochin; Moscow Russian Federation
| | - O. Kolomejtsev
- Oncology; National Research Center For Oncology Named After N.N. Blochin; Moscow Russian Federation
| | - Y. Ryabukhina
- Oncology; National Research Center For Oncology Named After N.N. Blochin; Moscow Russian Federation
| | - A. Semenova
- Oncology; National Research Center For Oncology Named After N.N. Blochin; Moscow Russian Federation
| | - N. Kokosadze
- Oncology; National Research Center For Oncology Named After N.N. Blochin; Moscow Russian Federation
| | - N. Kupryshina
- Oncology; National Research Center For Oncology Named After N.N. Blochin; Moscow Russian Federation
| | - I. Komarov
- Oncology; National Research Center For Oncology Named After N.N. Blochin; Moscow Russian Federation
| | - O. Malikhova
- Oncology; National Research Center For Oncology Named After N.N. Blochin; Moscow Russian Federation
| | - O. Ettinger
- Therapy; Russian National Research Medical University Named After N.I. Pirogov; Moscow Russian Federation
| | - S. Borisovskaya
- Therapy; Russian National Research Medical University Named After N.I. Pirogov; Moscow Russian Federation
| | - I. Lazarev
- Hematology; City Clinical Hospital Named After C.P. Botkin; Moscow Russian Federation
| | - V. Ivanova
- Hematology; City Clinical Hospital Named After C.P. Botkin; Moscow Russian Federation
| | - R. Ivashhenko
- Therapy; Clinical Hospital Named After V.M. Buyanov; Moscow Russian Federation
| | - Y. Kemizh
- Therapy; Clinical Hospital Named After V.M. Buyanov; Moscow Russian Federation
| | - A. Alla Kovrigina
- Hematology; Research Center For Haematology; Moscow Russian Federation
| | - I. Nikitin
- Therapy; Russian National Research Medical University Named After N.I. Pirogov; Moscow Russian Federation
| | - O. Urvanceva
- Therapy; Clinical Hospital Named After V.M. Buyanov; Moscow Russian Federation
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Leonard J, Reeves J, Ferhanoglu B, Doner KT, Eom H, Flinn IW, Raposo J, Chowhan NM, Suh C, Noga S, Tumyan G, Aung S, Hajdenberg J, Ulrich BK, Pendergrass KB, Mulligan G, Rizo A, Kussick S, Offner F. PYRAMID and LYM2034: Targeted randomized phase II studies of bortezomib with or without immunochemotherapy in newly diagnosed nongerminal center B-cell-like (GCB) diffuse large B-cell lymphoma (DLBCL), including rapid prospective non-GCB subtype identification. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.tps226] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Poddubnaya I, Osmanov E, Babicheva L, Tumyan G, Sorokin E, Stefanov D. R-CHOP compared with CHOP in patients with diffuse large B-cell lymphoma (DLCL): Russian experience. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.18536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
18536 Background: R-CHOP is regarded as the best available treatment for untreated patients with aggressive and indolent B- NHL. Methods: 184 previously untreated patients with DLCL were included in retrospective study: 92 patients were treated by CHOP, 92 patients were treated by CHOP plus rituximab ( R-CHOP ). Age of patients ranged 16–87 years (median 50 years). The median follow- up was 18 months. Compared groups were balanced in all parameters. The advanced stage of disease (III-IV) at diagnosis had 66% patients treated with CHOP and 67,5 % patients treated with R-CHOP. =2 extranodal zones were initially revealed at 35% in CHOP group vs 47% in R- CHOP group. PS of 25 % patients in R-CHOP group and 30% patients in CHOP group was regarded as appropriate 3–4 degrees on ECOG. Increased LDH level was marked at 60% in CHOP-group vs 54% in R-CHOP. 29% patients in R-CHOP group and 21% patients in CHOP group had B-symptoms at diagnosis; bulky disease took place in 53% cases in R-CHOP group and 62% cases in CHOP. High IPI score had 47 % patients in CHOP-group vs 48 % in R-CHOP. Results: Complete response was achieved in 74% of the patients treated with R- CHOP, as compared to 56% of those treated with CHOP alone (p<0,05). Disease progression during treatment was reported in 25% of patients in CHOP group and 18,5% in R-CHOP group. Median overall survival in patients treated with R-CHOP was NS, in patients treated with CHOP alone was 16 months. With a median follow-up of 18 months, 29 (31,5%) events (progression - 18,5%, relapse - 10%, death - 3% ) were observed in the R-CHOP group and 48 (52%) events ( progression - 25%, relapse - 20%, death - 7%) in the CHOP group (p<0,05). Median event-free survival and relapse-free survival in the CHOP group was 12 months, in R-CHOP group NS. Toxicity was equivalent in both groups. Conclusions: We have established better direct efficiency and outcome of R-CHOP in any age of pts. No significant financial relationships to disclose.
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Affiliation(s)
- I. Poddubnaya
- Cancer Research Centre of RAMS, Moscow, Russian Federation
| | - E. Osmanov
- Cancer Research Centre of RAMS, Moscow, Russian Federation
| | - L. Babicheva
- Cancer Research Centre of RAMS, Moscow, Russian Federation
| | - G. Tumyan
- Cancer Research Centre of RAMS, Moscow, Russian Federation
| | - E. Sorokin
- Cancer Research Centre of RAMS, Moscow, Russian Federation
| | - D. Stefanov
- Cancer Research Centre of RAMS, Moscow, Russian Federation
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