Pregnancy Screening and Contraceptive Counseling in Young Women with Hodgkin Lymphoma: A Single Center Retrospective Review.

Purpose: Chemotherapeutic agents used to treat Hodgkin lymphoma are teratogenic. Pregnancy screening before the start of chemotherapy is supported by clinical guidelines. There are limited data on pregnancy screening before the start of Hodgkin therapy but previous studies suggest that it is not consistently completed. The objective of this study is to evaluate the completion of pregnancy screening before the start of chemotherapy in females with Hodgkin lymphoma. Methods: A retrospective chart review was performed for all female patients, regardless of age, with newly diagnosed Hodgkin lymphoma from 2000 to 2015 at the Hospital for Sick Children. Demographic, disease, and treatment data were captured. Outcome data included completion of pregnancy testing within 2 weeks before the start of therapy and documentation of contraceptive counseling. Results: One hundred twenty-two female patients with Hodgkin lymphoma between the ages of 5 and 17 years were identified. Sixty patients (49%) had β-human chorionic gonadotropin (β-HCG) testing done before the start of therapy. Testing modalities included serum and urine qualitative and serum quantitative β-HCG tests. Older age (p < 0.01), documentation of menstrual status (p = 0.02), and diagnosis between 2008 and 2015 (p < 0.01) were associated with higher incidence of screening, although enrollment on a therapeutic trial was not (p = 0.37). Contraceptive counseling was documented for 19 patients (16%), and 11 patients (9%) were prescribed contraceptive medications. Conclusion: Prechemotherapy pregnancy screening was completed on less than half of females with Hodgkin lymphoma. The adoption of strategies to improve the consistency of pregnancy screening is required.