Journal of Clinical Oncology, Vol 11, 507-512, Copyright © 1993 by American Society of Clinical Oncology
Pregnancy outcome in patients treated for Hodgkin's disease
J Aisner, PH Wiernik and P Pearl
University of Maryland Cancer Center, Baltimore 21201.
PURPOSE: This study attempted to determine the outcome of pregnancies in
patients (or their partners) who were successfully treated for Hodgkin's
disease and to assess the effect of treatment on the children of the
treated parents. MATERIALS AND METHODS: A questionnaire was distributed to
and personal interviews were conducted with patients who were of
reproductive age at the time of treatment with consecutive protocols of
radiotherapy, chemotherapy, or both. Those premenopausal patients (or the
sexual partners of patients) who attempted to conceive after successful
treatment constituted the study population. Fertility assessment was based
only on those patients identified as desiring children. RESULTS: Among 391
adult patients, 221 patients (104 females and 117 males) of reproductive
age were interviewed. Before treatment, 63 of the 221 patients had 135
pregnancies, which resulted in 118 children, 11 spontaneous abortions, five
elective abortions, and one stillborn. After treatment, 94 patients (43
females and 51 males) actively attempted conception; 35 females and 25
partners of male patients had 84 pregnancies, which resulted in 68 living
children. Among the 84 pregnancies, there were one premature birth at 29
weeks, three spontaneous abortions, 11 elective abortions, and two
stillborn: one at 32 weeks and one set of twins. The children have been
observed for a median of 11 years (minimum follow up > 4.5 years). Of
those patients who desired children, 35 of 43 females became pregnant,
whereas only 25 of the 51 partners of male patients became pregnant. At
least five male patients with low sperm counts apparently fathered
children. CONCLUSIONS: This study demonstrates that both men and women have
the potential for fertility after treatment regardless of treatment
modality. The partners of male patients who were treated with combined
modality treatment had a lower frequency of pregnancy than did the female
patients who attempted conception and their frequency of pregnancy was also
lower than the general population. There was no apparent increase in
complications of pregnancy, spontaneous abortions, or congenital
abnormalities after treatment compared with pregnancies in this patient
group before treatment or with pregnancies in the general population.
