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Blood, 1 January 2008, Vol. 111, No. 1, pp. 101-108. Prepublished online as a Blood First Edition Paper on September 21, 2007; DOI 10.1182/blood-2007-05-090225. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2007-05-090225v1 111/1/101    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by De Bruin, M. L. Articles by van Leeuwen, F. E. Search for Related Content PubMed PubMed Citation Articles by De Bruin, M. L. Articles by van Leeuwen, F. E. Related Collections Neoplasia Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Treatment-related risk factors for premature menopause following Hodgkin lymphoma Marie L. De Bruin1, Jeannine Huisbrink1,2, Michael Hauptmann3, Marianne A. Kuenen1, Gabey M. Ouwens1, Mars B. van't Veer4, Berthe M. P. Aleman5, and Flora E. van Leeuwen1 1 Department of Epidemiology, the Netherlands Cancer Institute, Amsterdam; 2 Utrecht Institute for Pharmaceutical Sciences (UIPS), Division of Pharmacoepidemiology and Pharmacotherapy, Utrecht; 3 Department of Bioinformatics and Statistics, the Netherlands Cancer Institute, Amsterdam; 4 Department of Hematology, Erasmus Medical Center (MC), Daniel den Hoed Cancer Center, Rotterdam; and 5 Department of Radiotherapy, the Netherlands Cancer Institute, Amsterdam, the Netherlands We conducted a cohort-study among 518 female 5-year Hodgkin lymphoma (HL) survivors, aged 14 to 40 years (median: 25 years) at treatment (1965-1995). Multivariable Cox regression was used to quantify treatment effects on risk of premature menopause, defined as cessation of menses before age 40 years. After a median follow up of 9.4 years, 97 women had reached menopause before age 40 years. Chemotherapy was associated with a 12.3-fold increased risk of premature menopause compared with radiotherapy alone. Treatment with MOPP (mechlorethamine, vincristine, procarbazine, prednisone)/ABV (doxorubicine, bleomycine, vinblastine) significantly increased the risk of premature menopause (hazard ratio [HR]: 2.9), although to a lesser extent than MOPP treatment (HR: 5.7). Alkylating agents, especially procarbazine (HR: 8.1) and cyclophosphamide (HR: 3.5), showed the strongest associations. Ten years after treatment, the actuarial risk of premature menopause was 64% after high cumulative doses (> 8.4 g/m2) and 15% after low doses ( 4.2 g/m2) of procarbazine. The cumulative risk of menopause at age 40 years did not differ much according to age, but time to premature menopause was much longer in women treated at early ages. As long as alkylating agents will be used for curing HL, premature menopause will remain a frequent adverse treatment effect, with various clinical implications. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

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