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- Title
Fertility-Preserving Treatments and Patient- and Parental Satisfaction on Fertility Counseling in a Cohort of Newly Diagnosed Boys and Girls with Childhood Hodgkin Lymphoma.
- Authors
Drechsel, Katja C. E.; IJgosse, Irene M.; Slaats, Sofie; Raasen, Lisanne; Stoutjesdijk, Francis S.; van Dulmen-den Broeder, Eline; Wallace, W. Hamish; Beishuizen, Auke; Körholz, Dieter; Mauz-Körholz, Christine; Cepelova, Michaela; Uyttebroeck, Anne; Ronceray, Leila; Kaspers, Gertjan J. L.; Broer, Simone L.; Veening, Margreet A.
- Abstract
Simple Summary: Most children diagnosed with (classical) Hodgkin lymphoma survive, but chemotherapy and radiotherapy can harm their fertility. There are several fertility-preserving treatments available that can be used in effort to preserve reproductive ability. In this observational study, we studied how often fertility-preserving treatments were used in a cohort of children with newly diagnosed classical Hodgkin lymphoma and evaluated the patient- and treatment characteristics of those receiving such co-treatments. Furthermore, we surveyed patients and parents/guardians to gain insight into their opinion and satisfaction on the offered fertility counseling. Most patients and parents/guardians had received fertility counseling. Most participants were satisfied about the offered counseling and found it important. Concerns about (future) fertility were common. This study emphasizes the importance of fertility counseling and the consideration of fertility preservation based on the expected risk of infertility and patient characteristics. The evaluation of fertility care is important considering the impact of (in)fertility on quality of life. Purpose: The purpose of this study is to evaluate the use of fertility-preserving (FP) treatments and fertility counseling that was offered in a cohort of newly diagnosed children with classical Hodgkin lymphoma (cHL). Methods: In this observational study, boys and girls with cHL aged ≤ 18 years with scheduled treatment according to the EuroNet-PHL-C2 protocol were recruited from 18 sites (5 countries), between January 2017 and September 2021. In 2023, a subset of Dutch participants (aged ≥ 12 years at time of diagnosis) and parents/guardians were surveyed regarding fertility counseling. Results: A total of 101 boys and 104 girls were included. Most post-pubertal boys opted for semen cryopreservation pre-treatment (85% of expected). Invasive FP treatments were occasionally chosen for patients at a relatively low risk of fertility based on scheduled alkylating agent exposure (4/5 testicular biopsy, 4/4 oocyte, and 11/11 ovarian tissue cryopreservation). A total of 17 post-menarchal girls (20%) received GnRH-analogue co-treatment. Furthermore, 33/84 parents and 26/63 patients responded to the questionnaire. Most reported receiving fertility counseling (97%/89%). Statements regarding the timing and content of counseling were generally positive. Parents and patients considered fertility counseling important (94%/87% (strongly agreed) and most expressed concerns about (their child's) fertility (at diagnosis 69%/46%, at present: 59%/42%). Conclusion: Systematic fertility counseling is crucial for all pediatric cHL patients and their families. FP treatment should be considered depending on the anticipated risk and patient factors. We encourage the development of a decision aid for FP in pediatric oncology.
- Subjects
CRYOPRESERVATION of organs, tissues, etc.; RESEARCH funding; SCIENTIFIC observation; QUESTIONNAIRES; PARENT attitudes; GONADOTROPIN releasing hormone; FERTILITY preservation; PATIENT satisfaction; COUNSELING; HODGKIN'S disease; ADOLESCENCE; CHILDREN
- Publication
Cancers, 2024, Vol 16, Issue 11, p2109
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers16112109