Gonadal function in young patients successfully treated for Hodgkin disease Journal Article
| Authors: | Papadakis, V.; Vlachopapadopoulou, E.; Van Syckle, K.; Ganshaw, L.; Kalmanti, M.; Tan, C.; Sklar, C. |
| Article Title: | Gonadal function in young patients successfully treated for Hodgkin disease |
| Abstract: | Background. Gonadal function in pediatric and young adult survivors of Hodgkin disease is not very well defined. This study evaluates the outcome following the Multiple Drug Protocol (MDP) and the results are compared to the published experience. Procedure. Ovarian and testicular function was assessed in 65 patients (36 males) with Hodgkin disease in first or second complete remission after treatment with either radiation (RT, n = 13), chemotherapy (CT, n = 9), or both (n = 43). Chemotherapy consisted of six cycles of the MDP (doxorubicin, procarbazine, prednisone, vincristine, and cyclophosphamide). Median age at diagnosis was 13.1 years (range, 2.4-22.6) and median age at evaluation was 22.6 years (range, 15.1-33.7), which was 6.7 years (range, 2.0-19.8) after the completion of all treatments. For the purpose of analysis, patients were divided into three groups: group A, patients who received only RT that did not include the pelvis (8 females, 5 males); group B, patients who received CT but no pelvic RT (15 females, 25 males); and group C, patients who received CT plus pelvic RT (6 females, 6 males). Results. All patients progressed spontaneously through puberty and evaluable patients were found to be sexually mature (Tanner stage IV and V). Serum follicle stimulating hormone (FSH) was increased in 0/5, 13/25, and 5/6 and testicular volume was decreased in 1/3, 4/11, and 2/3 group A, B, and C male patients, respectively. Leydig cell dysfunction was uncommon; 91% and 88% of males had normal serum concentrations of luteinizing hormone (LH) and testosterone, respectively. FSH and LH were increased in 0/8, 3/15, and 2/6 group A, B, and C female patients, respectively, at last follow-up, indicating a 17% prevalence of ovarian dysfunction. Serial data in seven females whose initial levels of FSH/LH were elevated revealed normalization in four. Six females delivered eight normal children. Conclusions. The majority of males who received CT ± RT have evidence of germ cell dysfunction, while Leydig cell function is unaffected in most. In females, although abnormal function early after the end of treatment was observed, ovarian function remained or returned to normal in most young women. Thus, in females the results of hormone testing performed early after treatment may not be predictive of their eventual reproductive potential. |
| Keywords: | adolescent; adult; cancer chemotherapy; child; treatment outcome; child, preschool; functional assessment; major clinical study; prednisone; doxorubicin; follow-up studies; antineoplastic combined chemotherapy protocols; cyclophosphamide; vincristine; procarbazine; hodgkin disease; leydig cell; late effects; ovary; prednisolone; testosterone blood level; fertility; testosterone; testis; chlorambucil; intravenous drug administration; follitropin; oral drug administration; hormone blood level; luteinizing hormone; ovary function; follitropin blood level; gonad function; humans; human; male; female; priority journal; article; testicular diseases; gonadal function; testis function; ovarian diseases |
| Journal Title: | Medical and Pediatric Oncology |
| Volume: | 32 |
| Issue: | 5 |
| ISSN: | 0098-1532 |
| Publisher: | Wiley Liss |
| Date Published: | 1999-05-01 |
| Start Page: | 366 |
| End Page: | 372 |
| Language: | English |
| DOI: | 10.1002/(sici)1096-911x(199905)32:5<366::aid-mpo10>3.0.co;2-7 |
| PUBMED: | 10219339 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 16 August 2016 -- Source: Scopus |
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3Ganshaw -
10Van Syckle -
12Papadakis
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