[Gonadal function in young men after the treatment for Hodgkin lymphoma].
BACKGROUND
The survival rate after the treatment for Hodgkin lymphoma improved in the last three decades and the late effects of anticancer therapy, particularly gonadal toxicity, became an important problem.


OBJECTIVE
Assessment of the influence of chemo- and radiotherapy on gonadal function in young male survivors after the treatment for Hodgkin lymphoma (HL).


METHODS
Levels of inhibin B, testosterone, FSH, LH and testicular volume were measured in 26 HL survivors aged from 15.6 to 25.2, who had been treated for HL in prepubertal (n=8) or pubertal (n=18) period.


RESULTS
1. In all groups, comparing to control one, we found higher FSH concentration (15.2+/-12.3 IU/l vs. 3.3+/-1.2 IU/l); p=0.0004, lower inhibin B (60.9+/-44.5 ng/l vs. 198.1+/-58.1 ng/l); p=0.0001, lower testicular volume (18.2+/-2.6ml vs. 21.3 +/-5.1ml) p=0.01 and normal LH as well as testosterone values. 2. Higher >+2SD FSH and LH were found in 62% and 23%, respectively, and lower <-2SD inhibin B - in 72% of survivors. 3. We did not observe the differences between the patients: a) treated before and during puberty and b) the patients in different stages of disease. 4. Persistently lowered inhibin B concentration and higher, but gradually normalized values of FSH were found >6 years after the end of therapy, 5. Azoospermia was observed in 4/10 patients, oligospermia - in 4/10 and normospermia - only in 2/10.


CONCLUSIONS
Anticancer treatment for HL, independently of the age at diagnosis and clinical stage, leads to serious and persistent gonadal dysfunction. The patients should be informed about the problem of gonadal toxicity and possibility of fertility preservation at the moment of diagnosis.
Krawczuk-Rybak
Maryna
M
Klinika Onkologii i Hemetologii Dzieciecej Uniwersytetu Medycznego w Białymstoku, Białystok. rybak@umwb.edu.pl
Solarz
Elzbieta
E
Wojtkowska
Małgorzata
M
Wysocka
Jolanta
J
Matysiak
Michał
M
Gadomski
Artur
A
Kazanowska
Bernarda
B
Sega-Pondel
Dorota
D
D000293:Adolescent; D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005640:Follicle Stimulating Hormone / Q000378:metabolism; D006058:Gonadal Disorders / Q000209:etiology*; D006689:Hodgkin Disease / Q000628:therapy*; D006801:Humans; D007265:Inhibins / Q000378:metabolism; D008297:Male; D009929:Organ Size; D011878:Radiotherapy / Q000009:adverse effects*; D017741:Survivors / Q000706:statistics & numerical data*; D013737:Testis / Q000473:pathology; D013739:Testosterone / Q000378:metabolism; D055815:Young Adult
D000970:Antineoplastic Agents; C422364:inhibin B; D013739:Testosterone; D007265:Inhibins; D005640:Follicle Stimulating Hormone