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Start Over Descriptor "COMBINED-MODALITY" Topic 03 medical and health sciences
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1. Cardiovascular disease after treatment for Hodgkin's lymphoma

Author

Maraldo, M.V., Giusti, F., Vogelius, I.R., Lundemann, M., Kaaij, M.A. van der, Ramadan, S., Meulemans, B., Henry-Amar, M., Aleman, B.M., Raemaekers, J.M.M., Meijnders, P., Moser, E.C., Kluin-Nelemans, H.C., Feugier, P., Casasnovas, O., Fortpied, C., Specht, L., Damage and Repair in Cancer Development and Cancer Treatment (DARE), Stem Cell Aging Leukemia and Lymphoma (SALL), Department of Oncology, Rigshospitalet, Copenhagen University Hospital, European Organisation for Research and Treatment of Cancer [Bruxelles] (EORTC), European Cancer Organisation [Bruxelles] (ECCO), Department of Internal Medicine and Institure for Cardiovascular Research-Vrije Universiteit, VU University Medical Center [Amsterdam], National Cancer Institute, Cairo University, Egypt, Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU), Netherlands Cancer Institute (NKI), Antoni van Leeuwenhoek Hospital, Department of Haematology, Radboud University Medical Center [Nijmegen], Middelheim Hospital, Champalimaud Clinical Center, University of Groningen [Groningen], Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service d'Hématologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital du Bocage, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Rigshospitalet Research Committee, the EORTC Cancer Research Fund, and the Sally Snowman Survivorship Fellowship., EORTC Lymphoma Grp, Internal medicine, and CCA - Innovative therapy

Subjects
Male, Heart disease, [SDV]Life Sciences [q-bio], medicine.medical_treatment, COMBINED-MODALITY, 030204 cardiovascular system & hematology, 0302 clinical medicine, INVOLVED-FIELD RADIOTHERAPY, EUROPEAN ORGANIZATION, Risk Factors, Anthracyclines, Survivors, Randomized Controlled Trials as Topic, Cumulative dose, Hematology, Middle Aged, Hodgkin Disease, CANCER, COOPERATIVE GROUP, 3. Good health, Cardiovascular Diseases, 030220 oncology & carcinogenesis, Female, Rare cancers Radboud Institute for Health Sciences [Radboudumc 9], medicine.drug, Adult, Vincristine, medicine.medical_specialty, HEART-DISEASE, Radiation Dosage, 03 medical and health sciences, Young Adult, Internal medicine, RADIATION-THERAPY, medicine, Humans, Vinca Alkaloids, Aged, Retrospective Studies, Cardiotoxicity, Radiotherapy, business.industry, Retrospective cohort study, medicine.disease, Hodgkin's lymphoma, Surgery, IRRADIATION, Radiation therapy, MYOCARDIAL-INFARCTION, CLINICAL STAGE-I, Heart failure, Human medicine, business
Abstract

Item does not contain fulltext BACKGROUND: Cardiovascular disease after treatment is an important concern in cancer survivors. However, knowledge of cardiotoxicity is limited by the retrospective nature of data, which often does not contain details of treatment exposure. To facilitate individual risk counselling of patients, we aimed to quantify the effect of anthracyclines, vinca-alkaloids, and radiotherapy on the risk of cardiovascular disease in patients treated for Hodgkin's lymphoma. METHODS: In 2009-10, a Life Situation Questionnaire (LSQ) was distributed to patients by mail to assess late-onset effects of Hodgkin's lymphoma treatment in patients who were included in nine successive European Organisation for Research and Treatment of Cancer (EORTC) and the Groupe d'Etude des Lymphomes de l'Adulte (GELA, now renamed LYSA) randomised trials between 1964 and 2004. We reconstructed the mean radiation doses to the heart and carotid arteries and the cumulative doses of anthracyclines and vinca-alkaloids for all patients. Incidence of cardiovascular disease was reported during follow-up and updated through the LSQ. We applied Cox proportional hazards regression analyses to quantify the effect of chemotherapy and radiation on the risk of a first cardiovascular disease event. FINDINGS: Information of primary treatment was complete for 6039 patients (median age at diagnosis 30 years [IQR 23-40]; median length of follow-up 9 years [6-14]). 1919 patients responded to the LSQ. 1238 first cardiovascular events were recorded in 703 patients, most were ischaemic heart disease (132 [19%]), congestive heart failure (85 [12%]), arrhythmia (110 [16%]), and valvular disease (77 [11%]). The mean heart radiation dose per 1 Gy increase (HR 1.015 [95% CI 1.006-1.024], p=0.0014) and the dose of anthracyclines per 50 mg/m(2) increase in cumulative dose (1.077 [1.021-1.137], p=0.0064) were significant predictors of cardiovascular disease. Cumulative dose of vinblastine (unadjusted model p=0.77), vincristine (p=0.36), and mean radiation dose to the left (p=0.41) or right (p=0.70) internal carotid artery did not predict for cardiovascular events. INTERPRETATION: Quantification of the increased cardiovascular risk with specific doses of radiation and anthracycline exposure will enable a quantitative assessment of the optimum combination of systemic therapy and radiation, which will help clinicians to balance the risks and benefits of different regimens for individual patients. FUNDING: Rigshospitalet Research Committee, the EORTC Cancer Research Fund, and the Sally Snowman Survivorship Fellowship.

Published
2015

2. Parenthood in Survivors of Hodgkin Lymphoma

Author

Francisca Ong, Christophe Fruchart, Aspasia Stamatoullas, Marc André, Edwige Abeilard-Lemoisson, Jeanette K. Doorduijn, Evert M. Noordijk, Catherine Sebban, John M. M. Raemaekers, Brice Dubois, José Thomas, Christophe Fermé, Bart Meulemans, Marleen A. E. van der Kaaij, Serge Bologna, Michele Spina, Anouk Allgeier, W.M. Smit, Pauline Brice, Hanneke C. Kluin-Nelemans, Pieternella J. Lugtenburg, Isabelle Gaillard, Lotte C. Moser, Michel Henry-Amar, Paul Meijnders, Arnold Simons, Berthe M.P. Aleman, Judith M. Roesink, Natacha Heutte, Centre d’études des transformations des activités physiques et sportives (CETAPS), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut de Recherche Interdisciplinaire Homme et Société (IRIHS), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Middelheim Hospital, European Organisation for Research and Treatment of Cancer [Bruxelles] (EORTC), European Cancer Organisation [Bruxelles] (ECCO), Cancers et Populations : Facteurs de Risque, Depistage, Pratiques Diagnostiques et Therapeutiques, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Gustave Roussy (IGR), Service d'hématologie, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Institut d'Hématologie de Basse-Normandie (IHBN), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Pierre Mendès France - Grenoble 2 (UPMF), Erasmus Medical Centre [Rotterdam, The Netherlands], Department of Medical Oncology, Centre Léon Bérard [Lyon], Université Henri Poincaré - Nancy 1 (UHP), Calvados Cancer Registry, Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), Department of Hematology, University of Groningen [Groningen], Damage and Repair in Cancer Development and Cancer Treatment (DARE), Stem Cell Aging Leukemia and Lymphoma (SALL), and Hematology

Subjects
Gerontology, Oncology, Male, Cancer Research, [SDV]Life Sciences [q-bio], COMBINATION CHEMOTHERAPY, COMBINED-MODALITY, Disease, THERAPY, DISEASE, 0302 clinical medicine, EUROPEAN ORGANIZATION, Surveys and Questionnaires, Medicine, 030212 general & internal medicine, Fertility preservation, Survivors, Young adult, 10. No inequality, ComputingMilieux_MISCELLANEOUS, SEX-RATIO, Randomized Controlled Trials as Topic, education.field_of_study, Fertility Preservation, Combination chemotherapy, Middle Aged, Hodgkin Disease, COOPERATIVE GROUP, 3. Good health, Europe, 030220 oncology & carcinogenesis, Female, Adult, medicine.medical_specialty, Adolescent, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, 03 medical and health sciences, Young Adult, Translational research [ONCOL 3], Internal medicine, Cooperative group, Humans, education, Aged, business.industry, Case-control study, RANDOMIZED-TRIALS, Fertility, Logistic Models, CLINICAL STAGE-I, Case-Control Studies, CHILDHOOD-CANCER SURVIVOR, Hodgkin lymphoma, Human medicine, business
Abstract

Purpose We investigated the impact of Hodgkin lymphoma (HL) on parenthood, including factors influencing parenthood probability, by comparing long-term HL survivors with matched general population controls. Patients and Methods A Life Situation Questionnaire was sent to 3,604 survivors treated from 1964 to 2004 in successive clinical trials. Responders were matched with controls (1:3 or 4) for sex, country, education, and year of birth (10-year groups). Controls were given an artificial date of start of treatment equal to that of their matched case. The main end point was presence of biologic children after treatment, which was evaluated by using conditional logistic regression analysis. Logistic regression analysis was used to analyze factors influencing spontaneous post-treatment parenthood. Results In all, 1,654 French and Dutch survivors were matched with 6,414 controls. Median follow-up was 14 years (range, 5 to 44 years). After treatment, the odds ratio (OR) for having children was 0.77 (95% CI, 0.68 to 0.87; P < .001) for survivors compared with controls. Of 898 survivors who were childless before treatment, 46.7% achieved post-treatment parenthood compared with 49.3% of 3,196 childless controls (OR, 0.87; P = .08). Among 756 survivors with children before treatment, 12.4% became parents after HL treatment compared with 22.2% of 3,218 controls with children before treatment (OR, 0.49; P < .001). Treatment with alkylating agents, second-line therapy, and age older than 35 years at treatment appeared to reduce the chances of spontaneous post-treatment parenthood. Conclusion Survivors of HL had slightly but significantly fewer children after treatment than matched general population controls. The difference concerned only survivors who had children before treatment and appears to have more personal than biologic reasons. The chance of successful post-treatment parenthood was 76%.

Published
2012

3. Sperm quality before treatment in patients with early stage Hodgkin's lymphoma enrolled in EORTC-GELA Lymphoma Group trials

Author

Caroline Bonmati, Houchingue Eghbali, José Thomas, Michel Henry-Amar, Patrice Carde, Evert M. Noordijk, John M. M. Raemaekers, Christophe Fermé, Marleen A. E. van der Kaaij, Natacha Heutte, Jannie van Echten-Arends, Pauline Brice, Hanneke C. Kluin-Nelemans, Centre d’études des transformations des activités physiques et sportives (CETAPS), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut de Recherche Interdisciplinaire Homme et Société (IRIHS), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Institut Gustave Roussy (IGR), Centre de génétique et de physiologie moléculaire et cellulaire (CGPhiMC), Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon, Service d'Hémato-oncologie [CHU Saint-Louis], Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Damage and Repair in Cancer Development and Cancer Treatment (DARE), and Stem Cell Aging Leukemia and Lymphoma (SALL)

Subjects
sperm quality, FERTILE MEN, [SDV]Life Sciences [q-bio], COMBINED-MODALITY, Gastroenterology, DISEASE, 0302 clinical medicine, EUROPEAN ORGANIZATION, immune system diseases, Risk Factors, hemic and lymphatic diseases, Sperm motility, reproductive and urinary physiology, ComputingMilieux_MISCELLANEOUS, media_common, Azoospermia, fertility, 030219 obstetrics & reproductive medicine, medicine.diagnostic_test, Sperm Count, Hodgkin's lymphoma, Smoking, Age Factors, Hematology, Middle Aged, Hodgkin Disease, Spermatozoa, CANCER, 3. Good health, 030220 oncology & carcinogenesis, Erythrocyte sedimentation rate, Sperm Motility, Original Article, GONADAL-FUNCTION, Adult, medicine.medical_specialty, endocrine system, Adolescent, Fever, media_common.quotation_subject, Fertility, [SDV.CAN]Life Sciences [q-bio]/Cancer, Blood Sedimentation, sperm, REGIONAL DIFFERENCES, 03 medical and health sciences, Semen quality, Young Adult, male, Translational research [ONCOL 3], Internal medicine, Weight Loss, medicine, Humans, YOUNG MEN, Neoplasm Staging, business.industry, urogenital system, medicine.disease, Sperm, RANDOMIZED-TRIALS, Surgery, Lymphoma, Logistic Models, SEMEN QUALITY, Follicle Stimulating Hormone, business
Abstract

Contains fulltext : 81517.pdf (Publisher’s version ) (Open Access) BACKGROUND: Although widely recommended, cryopreservation of sperm is sometimes not performed for patients with Hodgkin's lymphoma because of presumed poor sperm quality related to the disease. We investigated sperm quality and factors determining it in untreated patients with early stage Hodgkin's lymphoma. DESIGN AND METHODS: Of 2362 males who participated in EORTC H6-H9 trials, 474 (20%) had data available. Sperm quality was defined according to World Health Organization guidelines. Determining factors were studied by logistic regression analysis. RESULTS: The median sperm concentration was 40x10(6)/mL (range, 0-345x10(6)/mL) and the median motility 50% (range, 0-90%). Sperm quality was good (concentration >or=20x10(6)/mL and motility >or=50%), intermediate (concentration >or=5x10(6)/mL) and poor (concentration 0) in 41%, 49% and 7% of patients, respectively. Three percent of the patients were azoospermic. No relation was found between sperm quality and age or clinical stage of the Hodgkin's lymphoma, but B-symptoms and elevated erythrocyte sedimentation rate predicted poor sperm quality. The odds ratios for the association of poor sperm quality with the variables examined were: presence of B-symptoms, 2.77 (95% CI, 1.50-5.12; p=0.001); erythrocyte sedimentation rate of 50 mm/h or greater, 2.35 (95% CI, 1.24-4.43; p=0.009); fever, 3.22 (95% CI, 1.41-7.33; p=0.005), and night sweats, 3.78 (95% CI, 1.97-7.26; p

Published
2009

4. Premature Ovarian Failure and Fertility in Long-Term Survivors of Hodgkin's Lymphoma: A European Organisation for Research and Treatment of Cancer Lymphoma Group and Groupe d'Etude des Lymphomes de l'Adulte Cohort Study

Author

Berthe M.P. Aleman, Natacha Heutte, Jeanette K. Doorduijn, Elizabeth C. Moser, Hanneke C. Kluin-Nelemans, Pieternella J. Lugtenburg, Isabelle Gaillard, Serge Bologna, Michel Henry-Amar, Houchingue Eghbali, Franck Morschhauser, Marleen A. E. van der Kaaij, Arnold Simons, Catherine Sebban, Pauline Brice, Bart Meulemans, Marie Bouteloup, Christophe Fruchart, Paul Meijnders, Judith M. Roesink, John M. M. Raemaekers, Achiel Van Hoof, Christophe Fermé, Francisca Ong, José Thomas, Michele Spina, Anouk Allgeier, Aspasia Stamatoullas, Edwige Abeilard-Lemoisson, Evert M. Noordijk, Centre d’études des transformations des activités physiques et sportives (CETAPS), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut de Recherche Interdisciplinaire Homme et Société (IRIHS), Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Middelheim Hospital, European Organisation for Research and Treatment of Cancer [Bruxelles] (EORTC), European Cancer Organisation [Bruxelles] (ECCO), Institut Gustave Roussy (IGR), Service d'hématologie, Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Institut d'Hématologie de Basse-Normandie (IHBN), Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Pierre Mendès France - Grenoble 2 (UPMF), Université Henri Poincaré - Nancy 1 (UHP), Plateforme de génétique moléculaire des cancers d'Aquitaine, Institut Bergonié [Bordeaux], UNICANCER-UNICANCER, Erasmus Medical Centre [Rotterdam, The Netherlands], Groupe de Recherche sur les formes Injectables et les Technologies Associées - ULR 7365 (GRITA), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille, Department of Medical Oncology, Centre Léon Bérard [Lyon], Service d'Hematologie, Hospices Civils de Lyon (HCL)-Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Department of Hematology, University Hospital St Jan, Calvados Cancer Registry, Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN), University of Groningen [Groningen], Damage and Repair in Cancer Development and Cancer Treatment (DARE), Stem Cell Aging Leukemia and Lymphoma (SALL), Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN)-Centre Régional de Lutte contre le Cancer François Baclesse [Caen] (UNICANCER/CRLC), Normandie Université (NU)-UNICANCER-Tumorothèque de Caen Basse-Normandie (TCBN)-UNICANCER, Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), and Hematology

Subjects
Oncology, Cancer Research, endocrine system diseases, [SDV]Life Sciences [q-bio], COMBINATION CHEMOTHERAPY, COMBINED-MODALITY, Primary Ovarian Insufficiency, DISEASE, Cohort Studies, 0302 clinical medicine, INVOLVED-FIELD RADIOTHERAPY, Surveys and Questionnaires, Multicenter Studies as Topic, Survivors, MOPP, ComputingMilieux_MISCELLANEOUS, Randomized Controlled Trials as Topic, 030219 obstetrics & reproductive medicine, Combination chemotherapy, Hodgkin Disease, COOPERATIVE GROUP, female genital diseases and pregnancy complications, 3. Good health, Vinblastine, Premature ovarian failure, Europe, 030220 oncology & carcinogenesis, Female, Cohort study, medicine.drug, Adult, medicine.medical_specialty, Adolescent, [SDV.CAN]Life Sciences [q-bio]/Cancer, Disease-Free Survival, 03 medical and health sciences, Young Adult, SDG 3 - Good Health and Well-being, Translational research [ONCOL 3], Internal medicine, medicine, Humans, VINBLASTINE, Gynecology, Dose-Response Relationship, Drug, business.industry, Cancer, ABVD, medicine.disease, Hodgkin's lymphoma, RANDOMIZED-TRIALS, Lymphoma, Fertility, CLINICAL STAGE-I, Human medicine, business, Follow-Up Studies
Abstract

Purpose In this large cohort of Hodgkin's lymphoma survivors with long follow-up, we estimated the impact of treatment regimens on premature ovarian failure (POF) occurrence and motherhood, including safety of nonalkylating chemotherapy and dose-response relationships for alkylating chemotherapy and age at treatment. Patients and Methods The Life Situation Questionnaire was sent to 1,700 women treated in European Organisation for Research and Treatment of Cancer and Groupe d'Étude des Lymphomes de l'Adulte trials between 1964 and 2004. Women treated between ages 15 and 40 years and currently not using hormonal contraceptives (n = 460) were selected to assess occurrence of POF. Cumulative POF risk was estimated using the life-table method. Predictive factors were assessed by Cox regression analysis. Results Median follow-up was 16 years (range, 5 to 45 years). Cumulative risk of POF after alkylating chemotherapy was 60% (95% CI, 41% to 79%) and only 3% (95% CI, 1% to 7%) after nonalkylating chemotherapy (doxorubicin, bleomycin, vinblastine, and dacarbazine; epirubicin, bleomycin, vinblastine, and prednisone). Dose relationship between alkylating chemotherapy and POF occurrence was linear. POF risk increased by 23% per year of age at treatment. In women treated without alkylating chemotherapy at age younger than 32 years and age 32 years or older, cumulative POF risks were 3% (95% CI, 1% to 16%) and 9% (95% CI, 4% to 18%), respectively. If menstruation returned after treatment, cumulative POF risk was independent of age at treatment. Among women who ultimately developed POF, 22% had one or more children after treatment, compared with 41% of women without POF. Conclusion Nonalkylating chemotherapy carries little to no excess risk of POF. Dose-response relationships for alkylating chemotherapy and age at treatment are both linear. Timely family planning is important for women at risk of POF.

Published
2012

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