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• W4380079892 abstract "Background: R-DA-EPOCH and R-CHOP ± radiotherapy are the most commonly used regimens in PMBCL, a disease that primarily affects young women. The cure rate exceeds 80%. Consequently, treatment-related complications are increasingly recognized, with gonadal failure and amenorrhea playing a fundamental role, causing significant psychological and social impact. This is more prevalent in female patients, in whom collection and cryopreservation of oocytes/ovarian tissue are not applied in everyday clinical practice. Published data are scarce on this subject. The aim of this study is the prospective evaluation of gonadal function in young women with PMBCL who are receiving chemotherapy (CT) with the R-DA-EPOCH regimen. We present our preliminary results on 13 patients. Subjects and Methods: Women ≤40 years, receiving first-line treatment with 6 cycles of R-DA-EPOCH, were included. Up to date, 13 patients have been analyzed, with a median age of 27.5 years: 12 PMBCL, 1 grey zone lymphoma. Hormonal measurements were performed at pre-specified time points: before treatment (t0), during CT(t1), at the end of CT(t2) and every six months (t6, t12) thereafter. The following hormones were measured: follicle-stimulating hormone (FSH), lutenizing hormone (LH), progesterone (PG), estradiol (Ε2), anti-Mullerian hormone (ΑΜΗ). FSH reflects gonadal function in women (increased levels indicate gonadal dysfunction). AMH is considered to be the most sensitive biomarker for gonadal reserve (decreasing values correlate with ovarian insufficiency). E2 and progesterone are the major sex hormones. Results: Gonadal damage, reflected by the decrease in AMH, was evident [median values: 16.6 pmol/L(t0), 0.16 pmol/L(t1), 3,28 pmol/L(t2), amh0-1 p = 0.005, amh0-2 p = 0.028]. AMH values sharply decreased from the beginning to the middle of CT and remained low throughout the treatment period. After the end of CT, AMH remained low, and returned to normal values a year after the end of treatment. In contrast to AMH, no clear alteration was seen with FSH and LH possibly because 50% of the patients received prophylactic treatment with GnRH analogues, that blocks their release from the pituitary. Estradiol and progesterone did not change significantly. As far as the menstrual cycle is concerned, all patients reported cycle disorders, with 80% developing amenorrhea after the first cycle of immunochemotherapy. Conclusion: Gonadal function in female patients with PMBCL malignant lymphomas is affected by the R-DA-EPOCH regimen. Gonadal dysfunction was evident from treatment initiation and normalized a year after the end of CT, indicating a chemotherapy-dependent genotoxic effect. AMH proved as a more sensitive marker compared to FSH, as it is independent of menstrual cycle phases and of prophylactic GnRH analogue administration. Keywords: aggressive B-cell non-Hodgkin lymphoma, other, late effects in lymphoma survivors No conflicts of interests pertinent to the abstract." @default.
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• W4380079892 date "2023-06-01" @default.
• W4380079892 modified "2023-10-12" @default.
• W4380079892 title "EVALUATION OF FERTILITY IN WOMEN TREATED WITH THE R‐DA‐EPOCH REGIMEN FOR PRIMARY MEDIASTINAL B CELL LYMPHOMA (PMBCL)" @default.
• W4380079892 doi "https://doi.org/10.1002/hon.3165_557" @default.
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