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Hum. Reprod. Advance Access originally published online on April 7, 2005
Human Reproduction 2005 20(8):2247-2249; doi:10.1093/humrep/dei018
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© The Author 2005. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions{at}oupjournals.org

Fertility and ovarian function are preserved in women treated with an intensified regimen of cyclophosphamide, adriamycin, vincristine and prednisone (Mega-CHOP) for non-Hodgkin lymphoma

Eldad J. Dann1,4, Ron Epelbaum2, Irit Avivi1, Menachem Ben Shahar2, Nissim Haim2, Jacob M. Rowe2 and Zeev Blumenfeld3

1 Departments of Hematology and Bone Marrow Transplantation, 2 Oncology, 3 Obstetrics & Gynecology, Rambam Medical Center & Bruce Rapaport Faculty of Medicine, Technion, Haifa, Israel 31096

4 To whom correspondence should be addressed. Email: e_dann{at}rambam.health.gov.il

BACKGROUND: Intensive chemotherapy is widely used to improve the outcome of aggressive non-Hodgkin lymphoma (NHL). Since these regimens may cause premature ovarian failure (POF), the ovarian function was studied in 13 consecutive women aged ≤40 years, treated with four cycles of intensified CHOP (cyclophosphamide 2000–3000 mg/m2 per cycle doxorubicin 50 mg/m2, vincristine 1.4 mg/m2 (maximum 2 mg) and prednisone 100 mg/day were given every 3 weeks). METHODS: Patients aged <60 years with aggressive NHL were eligible for participating in a non-randomized phase II study if they had stage I, II, B, bulky, or stages III, IV disease with the age-adjusted international prognostic index of low–intermediate to high-risk score. Seven patients were concomitantly treated with D-TRP6-GnRH analogue (Decapeptyl; Ferring, Germany) for minimizing gonadal toxicity. RESULTS: With a median follow-up of 70 months only one patient had POF, while 12 patients retained fertility and eight conceived spontaneously delivering 12 healthy babies. CONCLUSION: It appears that high-dose cyclophosphamide does not affect the ovarian function or fertility in patients exposed to this medication during four consecutive cycles of intensified CHOP.

Key words: fertility/GnRH analogue/lymphoma/post-chemotherapy


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