Purpose: 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). Methods: 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. Results: 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%). Conclusion: 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.
目的：本研究旨在评估一组新诊断的儿童经典型霍奇金淋巴瘤（cHL）患者中，生育力保留（FP）治疗的应用及所提供的生育咨询情况。方法：在这项观察性研究中，于2017年1月至2021年9月期间，从18个中心（5个国家）招募了年龄≤18岁、计划按照EuroNet-PHL-C2方案接受治疗的cHL患儿（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。结果：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子冷冻保存（占预期人数的85%）。对于根据计划烷化剂暴露评估为生育力风险相对较低的患者，偶尔也选择了侵入性FP治疗（4/5例睾丸活检、4/4例卵母细胞冷冻保存和11/11例卵巢组织冷冻保存）。共有17名月经初潮后女孩（20%）接受了GnRH类似物联合治疗。此外，84名父母中的33名和63名患者中的26名回复了问卷。大多数报告接受了生育咨询（97%/89%）。关于咨询时机和内容的评价总体积极。父母和患者认为生育咨询很重要（94%/87%强烈同意），并且大多数对（其孩子的）生育力表示担忧（诊断时：69%/46%，目前：59%/42%）。结论：系统的生育咨询对所有儿童cHL患者及其家庭至关重要。应根据预期风险及患者个体因素考虑FP治疗。我们鼓励在儿科肿瘤学领域开发FP决策辅助工具。
肿瘤(癌症)患者之家