FERTILITY, REPRODUCTIVE OUTCOMES, AND HEALTH OF OFFSPRING, OF PATIENTS TREATED FOR HODGKINS-DISEASE - AN INVESTIGATION INCLUDING CHROMOSOMEEXAMINATIONS

Reproductive outcomes and health of offspring were investigated in 340 patients with Hodgkin's disease first treated at Mount Vernon Hospita l, Middlesex, England, at ages under 40 (females) or 45 (males) during 1970-91. Information on offspring was obtained from case-notes and po stal questionnaires to the patients. Eleven men and 16 women who had c onceived any children after treatment were then interviewed. There was no excess of stillbirths, low birthweight or congenital malformations , and no cancers have occurred in the 49 offspring after treatment. Th ere was a significant excess of twins, compared with national expectat ions, in offspring of female patients (RR = 8.52, P = 0.025). Aggregat ion of series from the literature also showed an excess of twins. Chro mosomes from cultures of peripheral lymphocytes from 45 children born to 25 patients (11 men and 14 women) after treatment were examined for numerical abnormalities and for structural abnormalities at the 550 o r greater band level of resolution. All were normal except in one chil d with Down's syndrome (47, XY, + 21), for whom we found the origin of the trisomy was from the parent without Hodgkin's disease. The chromo some constitution was also abnormal in one miscarriage (69, XXY; origi nating from the parent without Hodgkin's disease) and one termination (45, X; for which the parental origin could not be determined) after t reatment. The study adds to previous questionnaire data and for the fi rst time provides data also from chromosome analysis, that offspring o f patients treated in adulthood for Hodgkin's disease are not at great ly raised risk of genotoxic or other adverse outcomes as a consequence of their parent's treatment. The numbers of offspring assessed in the literature remains small, however, and surveillance of larger numbers of subjects is needed to enable reliable treatment-specific analyses.