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
Emma Children's Hospital, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, 1007 MB Amsterdam, The Netherlands.
Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands.
Cancers (Basel). 2024 May 31;16(11):2109. doi: 10.3390/cancers16112109.
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).
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.
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%).
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.
本研究旨在评估为一组新诊断的经典型霍奇金淋巴瘤（cHL）儿童提供的生育力保护（FP）治疗及生育咨询的应用情况。
在这项观察性研究中，2017年1月至2021年9月期间，从18个地点（5个国家）招募了年龄≤18岁、根据EuroNet-PHL-C2方案计划接受治疗的cHL男孩和女孩。2023年，对一部分荷兰参与者（诊断时年龄≥12岁）及其父母/监护人进行了关于生育咨询的调查。
共纳入101名男孩和104名女孩。大多数青春期后男孩选择在治疗前进行精液冷冻保存（占预期的85%）。基于计划的烷化剂暴露，对于生育风险相对较低的患者偶尔会选择侵入性FP治疗（4/5例睾丸活检、4/4例卵母细胞及11/11例卵巢组织冷冻保存）。共有17名初潮后女孩（20%）接受了促性腺激素释放激素（GnRH）类似物联合治疗。此外，84名父母中的33名以及63名患者中的26名回复了问卷。大多数人报告接受了生育咨询（97%/89%）。关于咨询时间和内容的陈述总体呈积极态度。父母和患者认为生育咨询很重要（94%/87%（强烈同意）），并且大多数人表达了对（其子女的）生育问题的担忧（诊断时69%/46%，目前：59%/42%）。
系统的生育咨询对所有儿科cHL患者及其家庭至关重要。应根据预期风险和患者因素考虑FP治疗。我们鼓励为儿科肿瘤学中的FP开发决策辅助工具。
