Gonadal function in patients treated for Hodgkin's disease in childhood

Abstract

BackgroundThe long-term survival of patients treated for Hodgkin`s disease (HD) in childhood is high and the chief concern is now being directed toward the late effects of the treatment, including the endocrine dysfunction.Patients and methods.Testicular and ovarian functions were assessed in 64 long term survivors (24 females, 40 males) treated for HD in childhood in Slovenia between 1972 and 1994. At diagnosis they were 3–16 years old and had gonadal evaluation 4–27 years later at the age of 13–34. Fifty-four (84%) patients received chemotherapy (ChT), 49 in combination with radiation therapy (RT), 10 received RT alone. Gonadal function was assessed by the clinical examination and measurement of serum concentrations of estradiol and testosterone. Serum levels of LH and FSH were determined in the basal state and after the stimulation.ResultsPrimary hypogonadism (PH) was found in 30 (47%) patients. Twenty-four of 40 (60%) males had PH with evidence of damage of germinal epithelium, 4 of them had evidence of damage of Leydig cells (LC) and 10 had evidence of dysfunction of LC as well. PH was found in 6 of 24 (25%) females.ConclusionsAfter therapy for HD PH was more frequent in males than in females. Not only RT but also alkylating agents and procarbazine alone caused damage of LC. Age of patient at the time of treatment was not an important risk factor for gonadal toxicity. Pelvic RT in combination with ChT is the most important risk factor of the development PH both, in males and females.

Hypogonadism After Childhood Cancer Treatment

“…On the other hand none of the male subjects after 6 or more cycles of MOPP ChT had normal function of germ cell epithelium. Our findings are in concordance with data from other studies establishing that MOPP or MOPP-like combinations, such as MVPP (mechlorethamine, vinblastine, procarbazine and prednisone) and COPP induce azoospermia in 90-100 % of pts with a 10-20% chance of recovery even 10 years after treatment (Chapman et al 1979, Diamond& Bercu 2001, Viviani et al 1985, Waxmann et al 1982, Whitehead et al 1982, Zaletel 2010). Recovery of spermatogenesis following MOPP therapy appears to be dose-related with 3 courses of MOPP representing a limiting gonadal exposure for the recovery, suggesting only partial killing of germinal stem cells (da Cunha et al 1984).…”

Urological Complications and BK Virus-Associated Diseases Under Allogenic Stem Cell Transplantation

“…Most studies were performed in paediatric stem cell transplantation or are retrospective analyses with a small number of cases [1,2,3,4,5,6,7]. The complications mentioned were mostly urological infections and haematuria [8].…”

Thyroid Dysfunction After Radiotherapy in Children with Hodgkin’s Lymphoma

“…В настоящее время существует множество исследований, доказыва-ющих, что пациенты, излеченные от ЛХ в детстве, оказываются в группе риска по возникновению ряда осложнений. Оказалось, что данная группа больных подвержена повышенному риску раз-вития вторых злокачественных новообразова-ний, а также возникновению патологий со сторо- ны эндокринной, легочной, сердечно-сосудистой и других систем организма [6,7]. Риск возникнове-ния рецидива с течением времени становится все меньше, однако риск реализации поздних ослож-нений лечения значительно повышается спустя десятки лет после завершения терапии [8,9].…”