Gonadal function in prepubertal boys following treatment for Hodgkin's disease.
OBJECTIVE
Gonadal functions were evaluated in 26 male patients with Hodgkin's disease (HD), who were in continuous unmaintained remission following combination chemotherapy consisting of COPP/MOPP.


METHODS
These patients had received chemotherapy during the prepubertal phase. The median duration after termination of chemotherapy was 72 months.


RESULTS
Semen analysis of 18 patients showed azoospermia. Hormonal analysis showed elevated mean levels follicle-stimulating hormone (FSH) and inhibin as compared to age-matched controls, whereas luteinizing hormone levels were only marginally elevated.


CONCLUSIONS
These results suggest that COPP/MOPP causes severe damage to germinal epithelium even when given during prepubertal age. Sertoli cells, which are responsible for secretion of inhibin, are resistant to these cytotoxic agents. Our data emphasize the lack of gross dysfunction of Leydig cells. It is possible that an alternative chemotherapy protocol (ABVD) may be used in young patients to minimize the gonadal damage.
Dhabhar
B N
BN
Department of Medical Oncology, Tata Memorial Hospital, Bombay, India.
Malhotra
H
H
Joseph
R
R
Garde
S
S
Bhasin
S
S
Sheth
A
A
Advani
S H
SH
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003520:Cyclophosphamide / Q000009:adverse effects; D005640:Follicle Stimulating Hormone / Q000097:blood; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008297:Male; D008466:Mechlorethamine / Q000009:adverse effects; D009845:Oligospermia / Q000139:chemically induced; D011241:Prednisone / Q000009:adverse effects; D011344:Procarbazine / Q000009:adverse effects; D011627:Puberty / Q000187:drug effects; D013737:Testis / Q000187:drug effects* / Q000473:pathology; D014750:Vincristine / Q000009:adverse effects
D011344:Procarbazine; D008466:Mechlorethamine; D014750:Vincristine; D003520:Cyclophosphamide; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone; D011241:Prednisone