Elizabeth C. Moser

Cryopreservation, semen use and the likelihood of fatherhood in male Hodgkin lymphoma survivors: An EORTC-GELA lymphoma group cohort study

STUDY QUESTION How does the successful cryopreservation of semen affect the odds of post-treatment fatherhood among Hodgkin lymphoma (HL) survivors? SUMMARY ANSWER Among 334 survivors who wanted to have children, the availability of cryopreserved semen doubled the odds of post-treatment fatherhood. WHAT IS KNOWN ALREADY Cryopreservation of semen is the easiest, safest and most accessible way to safeguard fertility in male patients facing cancer treatment. Little is known about what proportion of patients achieve successful semen cryopreservation. To our knowledge, neither the factors which influence the occurrence of semen cryopreservation nor the rates of fatherhood after semen has been cryopreserved have been analysed before. STUDY DESIGN, SIZE, DURATION This is a cohort study with nested case-control analyses of consecutive Hodgkin survivors treated between 1974 and 2004 in multi-centre randomized controlled trials. A written questionnaire was developed and sent to 1849 male survivors. PARTICIPANTS/MATERIALS, SETTING, METHODS Nine hundred and two survivors provided analysable answers. The median age at treatment was 31 years. The median follow-up after cryopreservation was 13 years (range 5-36). MAIN RESULTS AND THE ROLE OF CHANCE Three hundred and sixty-three out of 902 men (40%) cryopreserved semen before the start of potentially gonadotoxic treatment. The likelihood of semen cryopreservation was influenced by age, treatment period, disease stage, treatment modality and education level. Seventy eight of 363 men (21%) used their cryopreserved semen. Men treated between 1994 and 2004 had significantly lower odds of cryopreserved semen use compared with those treated earlier, whereas alkylating or second-line (chemo)therapy significantly increased the odds of use; no other influencing factors were identified. We found an adjusted odds ratio of 2.03 (95% confidence interval 1.11-3.73, P = 0.02) for post-treatment fatherhood if semen cryopreservation was performed. Forty-eight out of 258 men (19%) who had children after HL treatment became a father using cryopreserved semen. LIMITATIONS, REASONS FOR CAUTION Data came from questionnaires and so this study potentially suffers from response bias. We could not perform an analysis with correction for duration of follow-up or provide an actuarial use rate due to lack of dates of semen utilization. We do not have detailed information on either the techniques used in cryopreserved semen utilization or the number of cycles needed. STUDY FUNDING/COMPETING INTERESTS Lance Armstrong Foundation, Dutch Cancer Foundation, René Vogels Stichting, no competing interests.

CARDIAC DISEASE PREDICTION FOLLOWING HODGKIN LYMPHOMA: AN EORTC LYMPHOMA GROUP AND GELA FOLLOW-UP STUDY

174 CARDIAC DISEASE PREDICTION FOLLOWING HODGKIN LYMPHOMA: AN EORTC LYMPHOMA GROUP AND GELA FOLLOW‐UP STUDY M.V. Maraldo* | F. Giusti | M.A. van der Kaaij | M. Henry‐Amar | B. Aleman | J. Raemaekers | P. Meijnders | E.C. Moser | H.C. Kluin‐Nelemans | M. Spina | C. Ferme | C. Fortpied | L. Specht Department of Clinical Oncology, Rigshospitalet, Copenhagen, Denmark; Department of Statistics, EORTC Headquarters, Brussels, Belgium; Department of Internal Medicine, VU University Medical Centre, Amsterdam, Netherlands; Centre de Traitement des Données du Cancéropôle Nord‐Ouest, Centre François Baclesse, Caen, France; Department of Radiation Oncology, the Netherlands Cancer Institute, Amsterdam, Netherlands; Department of Hematology, Radboud University Medical Center, Nijmegen, Netherlands; Department of Radiation Oncology, Iridium Cancer Network, University of Antwerp, Antwerp, Belgium; Department of Radiation Oncology, Champalimaud Cancer Centre, Lisbon, Portugal; Department of Hematology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands; Division of Medical Oncology, National Cancer Institute, Aviano, Italy; Department of Hematology, Institut Gustave Roussy, Villejuif, France