Reversal of fludarabine induced testicular damage in a patient with chronic lymphocytic leukaemia (CLL), by suppression of pituitary-testicular axis using gonadotrophin releasing hormone (GnRH).
We describe a case of a 47 year old man with CLL who was treated with 7 courses of fludarabine with simultaneous suppression of his pituitary-testicular axis (P-T) with Gonadotrophin releasing hormone (GnRH) and replacement treatment with testosterone. Despite initial gonadal damage as evident by endocrine and sperm studies, testicular recovery was observed 11 months post treatment. Although spontaneous recovery cannot be ruled out, continuous treatment with GnRH and testosterone may play a crucial role protecting the gonads from the cytotoxic effects of the chemotherapeutic agents.
Chatterjee
R
R
Reproductive Medicine Unit, Department Of Obstetrics and Gynaecology; University College London Hospitals, Huntley street. London WC1E6AU, UK.
Kottaridis
P D
PD
McGarrigle
H
H
Goldstone
A H
AH
D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D004703:Endocrine System / Q000187:drug effects; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000187:drug effects*; D013076:Sperm Count; D013733:Testicular Diseases / Q000139:chemically induced* / Q000188:drug therapy* / Q000473:pathology; D013737:Testis / Q000187:drug effects*; D013739:Testosterone / Q000008:administration & dosage; D014740:Vidarabine / Q000009:adverse effects* / Q000031:analogs & derivatives / Q000627:therapeutic use
D000970:Antineoplastic Agents; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone; D014740:Vidarabine; C024352:fludarabine