{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T16:50:27Z","timestamp":1792601427566,"version":"4.5.0"},"reference-count":36,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006244","name":"Dutch charity foundation \u201cKika\u201d","doi-asserted-by":"publisher","award":["project 257"],"award-info":[{"award-number":["project 257"]}],"id":[{"id":"10.13039\/501100006244","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>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 \u2264 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 \u2265 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\u2019s) 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.<\/jats:p>","DOI":"10.3390\/cancers16112109","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T11:43:48Z","timestamp":1717155828000},"page":"2109","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Fertility-Preserving Treatments and Patient- and Parental Satisfaction on Fertility Counseling in a Cohort of Newly Diagnosed Boys and Girls with Childhood Hodgkin Lymphoma"],"prefix":"10.3390","volume":"16","author":[{"given":"Katja C. E.","family":"Drechsel","sequence":"first","affiliation":[{"name":"Emma Children\u2019s Hospital, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, 1007 MB Amsterdam, The Netherlands"},{"name":"Princess M\u00e1xima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands"},{"name":"Cancer Center Amsterdam, Amsterdam University Medical Center, Vrije Universiteit Medical Center, 1007 MB Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-5476-2978","authenticated-orcid":false,"given":"Irene M.","family":"IJgosse","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0439-1656","authenticated-orcid":false,"given":"Sofie","family":"Slaats","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1486-6280","authenticated-orcid":false,"given":"Lisanne","family":"Raasen","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francis S.","family":"Stoutjesdijk","sequence":"additional","affiliation":[{"name":"Emma Children\u2019s Hospital, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, 1007 MB Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eline","family":"van Dulmen-den Broeder","sequence":"additional","affiliation":[{"name":"Emma Children\u2019s Hospital, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, 1007 MB Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Hamish","family":"Wallace","sequence":"additional","affiliation":[{"name":"Department of Haematology\/Oncology, Royal Hospital for Sick Children, Edinburgh EH16 4TJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6482-1823","authenticated-orcid":false,"given":"Auke","family":"Beishuizen","sequence":"additional","affiliation":[{"name":"Princess M\u00e1xima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands"},{"name":"Department of Haematology\/Oncology, Erasmus MC-Sophia Children\u2019s Hospital, 3000 CA Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieter","family":"K\u00f6rholz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Universit\u00e4tsklinikum Giessen und Marburg GmbH, Standort Giessen\u2014Zentrum f\u00fcr Kinderheilkunde und Jugendmedizin, Feulgenstr. 12, 35392 Giessen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8205-8665","authenticated-orcid":false,"given":"Christine","family":"Mauz-K\u00f6rholz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Universit\u00e4tsklinikum Giessen und Marburg GmbH, Standort Giessen\u2014Zentrum f\u00fcr Kinderheilkunde und Jugendmedizin, Feulgenstr. 12, 35392 Giessen, Germany"},{"name":"Clinic for Paediatric and Adolescent Medicine, Medical Faculty of the Martin-Luther University of Halle, Ernst-Grube-Str. 40, 06120 Halle, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michaela","family":"Cepelova","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Faculty Hospital Motol and 2nd Medical Faculty, Charles University, V \u00davalu 84, 150 06 Prague 5, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5644-424X","authenticated-orcid":false,"given":"Anne","family":"Uyttebroeck","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology and Oncology, KU Leuven, UZ Leuven, Herestraat 49, 3000 Leuven, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila","family":"Ronceray","sequence":"additional","affiliation":[{"name":"Pediatric Hematology and Oncology, St. Anna Children\u2019s Hospital, Medical University of Vienna, Kinderspitalgasse 6, A-1090 Wien, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7716-8475","authenticated-orcid":false,"given":"Gertjan J. L.","family":"Kaspers","sequence":"additional","affiliation":[{"name":"Emma Children\u2019s Hospital, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, 1007 MB Amsterdam, The Netherlands"},{"name":"Princess M\u00e1xima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone L.","family":"Broer","sequence":"additional","affiliation":[{"name":"Department of Reproductive Medicine & Gynecology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margreet A.","family":"Veening","sequence":"additional","affiliation":[{"name":"Emma Children\u2019s Hospital, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Pediatric Oncology, Cancer Center Amsterdam, 1007 MB Amsterdam, The Netherlands"},{"name":"Princess M\u00e1xima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/S1470-2045(21)00470-8","article-title":"Response-Adapted Omission of Radiotherapy and Comparison of Consolidation Chemotherapy in Children and Adolescents with Intermediate-Stage and Advanced-Stage Classical Hodgkin Lymphoma (EuroNet-PHL-C1): A Titration Study with an Open-Label, Embedded, Multinational, Non-Inferiority, Randomised Controlled Trial","volume":"23","author":"Balwierz","year":"2022","journal-title":"Lancet Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"733","DOI":"10.6004\/jnccn.2021.0027","article-title":"Pediatric Hodgkin Lymphoma, Version 3.2021","volume":"19","author":"Flerlage","year":"2021","journal-title":"JNCCN J. Natl. Compr. Cancer Netw."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1016\/j.ecl.2015.08.002","article-title":"Gonadal Function and Fertility Among Survivors of Childhood Cancer","volume":"44","author":"Antal","year":"2015","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2071","DOI":"10.1007\/s00432-013-1527-9","article-title":"Impact of Chemotherapy and Radiotherapy in Childhood on Fertility in Adulthood: The FeCt\u2014Survey of Childhood Cancer Survivors in Germany","volume":"139","author":"Reinmuth","year":"2013","journal-title":"J. Cancer Res. Clin. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1340","DOI":"10.1038\/s41591-023-02339-y","article-title":"A Joint International Consensus Statement for Measuring Quality of Survival for Patients with Childhood Cancer","volume":"29","author":"Hudson","year":"2023","journal-title":"Nat. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"6023","DOI":"10.1002\/cam4.5339","article-title":"Fertility Discussions and Concerns in Childhood Cancer Survivors, a Systematic Review for Updated Practice","volume":"12","author":"Demogeot","year":"2023","journal-title":"Cancer Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e57","DOI":"10.1016\/S1470-2045(20)30582-9","article-title":"Fertility Preservation for Male Patients with Childhood, Adolescent, and Young Adult Cancer: Recommendations from the PanCareLIFE Consortium and the International Late Effects of Childhood Cancer Guideline Harmonization Group","volume":"22","author":"Mulder","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_8","first-page":"382","article-title":"Fertility Preservation for Boys and Adolescents Facing Sterilizing Medical Therapy","volume":"3","author":"Hussein","year":"2014","journal-title":"Transl. Androl. Urol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2160","DOI":"10.1200\/JCO.2017.76.3839","article-title":"Improving Male Reproductive Health after Childhood, Adolescent, and Young Adult Cancer: Progress and Future Directions for Survivorship Research","volume":"36","author":"Kenney","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e45","DOI":"10.1016\/S1470-2045(20)30594-5","article-title":"Fertility Preservation for Female Patients with Childhood, Adolescent, and Young Adult Cancer: Recommendations from the PanCareLIFE Consortium and the International Late Effects of Childhood Cancer Guideline Harmonization Group","volume":"22","author":"Mulder","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1002\/uog.18934","article-title":"Gonadotropin-Releasing Hormone Agonists for Ovarian Protection during Cancer Chemotherapy: Systematic Review and Meta-Analysis","volume":"51","author":"Senra","year":"2018","journal-title":"Ultrasound Obs. Gynecol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1200\/JCO.2018.78.0858","article-title":"Gonadotropin-Releasing Hormone Agonists during Chemotherapy for Preservation of Ovarian Function and Fertility in Premenopausal Patients with Early Breast Cancer: A Systematic Review and Meta-Analysis of Individual Patient\u2013Level Data","volume":"36","author":"Lambertini","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3938","DOI":"10.1002\/cncr.29637","article-title":"Impact of Fertility Preservation Counseling and Treatment on Psychological Outcomes among Women with Cancer: A Systematic Review","volume":"121","author":"Deshpande","year":"2015","journal-title":"Cancer"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1080\/07347332.2018.1443986","article-title":"Factors Influencing the Provision of Fertility Counseling and Impact on Quality of Life in Adolescents and Young Adults with Cancer","volume":"36","author":"Skaczkowski","year":"2018","journal-title":"J. Psychosoc. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1710","DOI":"10.1002\/cncr.26459","article-title":"Pretreatment Fertility Counseling and Fertility Preservation Improve Quality of Life in Reproductive Age Women with Cancer","volume":"118","author":"Letourneau","year":"2012","journal-title":"Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1002\/pbc.24445","article-title":"A Worldwide Collaboration to Harmonize Guidelines for the Long-Term Follow-up of Childhood and Young Adult Cancer Survivors: A Report from the International Late Effects of Childhood Cancer Guideline Harmonization Group","volume":"60","author":"Kremer","year":"2013","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1016\/j.ejca.2018.08.007","article-title":"PanCareLIFE: The Scientific Basis for a European Project to Improve Long-Term Care Regarding Fertility, Ototoxicity and Health-Related Quality of Life after Cancer Occurring among Children and Adolescents","volume":"103","author":"Byrne","year":"2018","journal-title":"Eur. J. Cancer"},{"key":"ref_18","unstructured":"European Network-Paediatric Hodgkin Lymphoma Study Group (EuroNet-PHL) (2024, April 24). Second International Inter-Group Study for Classical Hodgkin Lymphoma in Children and Adolescent: EuroNet-PHL-C2; 2015, Available online: https:\/\/classic.clinicaltrials.gov\/ct2\/show\/NCT02684708."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"van der Perk, M.E.M., Stukait\u0117-Ruibien\u0117, E., Bumbulien\u0117, \u017d., Vaitkevi\u010dien\u0117, G.E., Bos, A.M.E., van den Heuvel-Eibrink, M.M., and Rascon, J. (2022). Development of a Questionnaire to Evaluate Female Fertility Care in Pediatric Oncology, a TREL Initiative. BMC Cancer, 22.","DOI":"10.1186\/s12885-022-09450-2"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1177\/0272989X03256005","article-title":"Validation of a Decision Regret Scale","volume":"23","author":"Brehaut","year":"2003","journal-title":"Med. Decis. Mak."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1177\/0272989X9501500105","article-title":"Validation of a Decisional Conflict Scale","volume":"15","year":"1995","journal-title":"Med. Decis. Mak."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1080\/07399332.2014.993036","article-title":"Validation of a Dutch Version of the Reproductive Concerns Scale (RCS) in Three Populations of Women","volume":"36","author":"Garvelink","year":"2015","journal-title":"Health Care Women Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1002\/pbc.24679","article-title":"The Cyclophosphamide Equivalent Dose as an Approach for Quantifying Alkylating Agent Exposure: A Report from the Childhood Cancer Survivor Study","volume":"61","author":"Green","year":"2014","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"S97","DOI":"10.5489\/cuaj.4410","article-title":"Fertility Preservation Options for Children and Adolescents with Cancer","volume":"11","author":"Romao","year":"2017","journal-title":"Can. Urol. Assoc. J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1093\/humupd\/dmad002","article-title":"Reproductive Ability in Survivors of Childhood, Adolescent and Young Adult Hodgkin Lymphoma: A Review","volume":"29","author":"Drechsel","year":"2023","journal-title":"Hum. Reprod. Update"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.rbmo.2015.11.005","article-title":"Semen Cryopreservation and Usage Rate for Assisted Reproductive Technology in 898 Men with Cancer","volume":"32","author":"Muller","year":"2016","journal-title":"Reprod. Biomed. Online"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Wnuk, K., \u015awitalski, J., Miazga, W., Tatara, T., Religioni, U., Olszewski, P., and Augustynowicz, A. (2023). The Usage of Cryopreserved Reproductive Material in Cancer Patients Undergoing Fertility Preservation Procedures. Cancers, 15.","DOI":"10.3390\/cancers15225348"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"737","DOI":"10.1016\/j.fertnstert.2024.02.029","article-title":"Can We Predict Menopause and Premature Ovarian Insufficiency?","volume":"121","author":"Laven","year":"2024","journal-title":"Fertil. Steril."},{"key":"ref_29","first-page":"CD001431","article-title":"Decision Aids for People Facing Health Treatment or Screening Decisions","volume":"2024","author":"Stacey","year":"2024","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"896939","DOI":"10.3389\/fonc.2022.896939","article-title":"Cancer, Fertility and Me: Developing and Testing a Novel Fertility Preservation Patient Decision Aid to Support Women at Risk of Losing Their Fertility Because of Cancer Treatment","volume":"12","author":"Jones","year":"2022","journal-title":"Front. Oncol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e68","DOI":"10.1016\/S1470-2045(20)30595-7","article-title":"Communication and Ethical Considerations for Fertility Preservation for Patients with Childhood, Adolescent, and Young Adult Cancer: Recommendations from the PanCareLIFE Consortium and the International Late Effects of Childhood Cancer Guideline Harmonization Group","volume":"22","author":"Mulder","year":"2021","journal-title":"Lancet Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.jadohealth.2008.08.014","article-title":"Fertility Preservation and Adolescent\/Young Adult Cancer Patients: Physician Communication Challenges","volume":"44","author":"Quinn","year":"2009","journal-title":"J. Adolesc. Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1093\/humrep\/dez062","article-title":"Professionals\u2019 Barriers in Female Oncofertility Care and Strategies for Improvement","volume":"34","author":"Baysal","year":"2019","journal-title":"Hum. Reprod."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"van der Perk, M.E., van der Kooi, A.-L.L.F., van de Wetering, M.D., IJgosse, I.M., van Dulmen-Den Broeder, E., Broer, S.L., Klijn, A.J., Versluys, A.B., Arends, B., and Oude Ophuis, R.J.A. (2021). Oncofertility Care for Newly Diagnosed Girls with Cancer in a National Pediatric Oncology Setting, the First Full Year Experience from the Princess M\u00e1xima Center, the PEARL Study. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0246344"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"2209","DOI":"10.1007\/s00520-017-4006-z","article-title":"Fertility Information Needs and Concerns Post-Treatment Contribute to Lowered Quality of Life among Young Adult Female Cancer Survivors","volume":"26","author":"Benedict","year":"2018","journal-title":"Support Care Cancer"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1996","DOI":"10.1002\/pbc.24672","article-title":"Discussing Fertility Preservation at the Time of Cancer Diagnosis: Dissatisfaction of Young Females","volume":"60","author":"Yeomanson","year":"2013","journal-title":"Pediatr. Blood Cancer"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/11\/2109\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:51:56Z","timestamp":1760107916000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/11\/2109"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,31]]},"references-count":36,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["cancers16112109"],"URL":"https:\/\/doi.org\/10.3390\/cancers16112109","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,31]]}}}