Burkitt lymphoma: Age Specific Fertility Rate in 113 long-term female survivors after treatment with cyclophosphamide

Abstract

Introduction: Reduced fertility risk is a risk in females treated with a high cumulative cyclophosphamide (CPM) dose. Objectives: The objective of this study is to establish the age at menarche, record all pregnancies, calculate age-specific fertility rate (ASFR) in female BL survivors, treated in Cameroon, in the age groups 15-19 and 20-24 years, and association with an increasing cumulative CPM dose. Methods: Data collection included personal data and telephone interviews for female survivors, aged ≥12 years with regards to menarche age, their mothers' menarche age, incidence and outcome of all pregnancies. The cumulative CPM/m2dose was categorized as low (<4723 mg/m2), medium (4724-10 635 mg/m/2) or high (>10 635 mg/m2). Results: The median age at first treatment for 113 patients was 8 years (range 3-17 years), with median current age 17 years (range 12-26 years); the median duration of follow-up was 9 years (range 1.2-13.3 years). The median age of patients at menarche (n = 109; 4 unknown) was 14 years (range 10-17 years, SD 1.19) and that of their mothers (n = 68; 45 unknown) 15 years (range 10-17 years, SD 1.53). The median time to first pregnancy following menarche (the fertility time) was 3.04 years (n = 10) with low-dose CPM, 6.09 years with medium-dose CPM (n = 81) and 6.04 years with high-dose CPM (n = 32) (log rank difference p = 0.420). The ASFR in the age group 15-19 years was 82.19 (n = 73) and in the age group 20-24 years was 863.6 (n = 22), with significantly lower ASFR (p > 0.001) in children treated before the age of 10 years. Conclusion: Fertility rates of girls treated for BL with CPM were normal but reduced in patients who commenced treatment before the age of 10 years.