Gonadal function in boys with newly diagnosed cancer before the start of treatment.
Are Inhibin B and testosterone levels reduced in boys with newly diagnosed cancer prior to therapy?



Pretreatment serum levels of Inhibin B and testosterone are significantly reduced in boys with newly diagnosed cancer, compared to reference values.



Disease-related gonadal impairment has been demonstrated in girls and young women diagnosed with cancer, prior to therapy.



We conducted a descriptive study in boys newly diagnosed with cancer between January 2006 and February 2014.



Serum Inhibin B and testosterone levels were determined in 224 boys, up to the age of 18 years, with newly diagnosed cancer prior to therapy. Hormone levels were compared with age-matched reference values. The cohort consisted of patients with acute lymphoblastic leukaemia (ALL), acute myeloid leukaemia (AML), Hodgkin lymphoma (HL), non-Hodgkin lym-phoma (NHL), nephroblastoma, neuroblastoma and sarcoma.



This study demonstrates reduced serum levels of Inhibin B in boys with newly diagnosed cancer, compared to reference values (standard deviation score (SDS) -0.9, P < 0.001). Median Inhibin B level in patients was 103.5 ng/l (range 20-422). Of all patients, 78.6% showed Inhibin B levels below the 50th percentile, and 58.5% had Inhibin B levels below the 25th percentile. Serum testosterone levels were significantly lower than the reference range population (SDS -1.2, P < 0.001). Median testosterone level in pubertal patients was 7.3 nmol/l (range 0.1-23.6). No correlation with clinical signs of general illness and hormone levels were observed.



In this study, reproductive hormone levels were compared with age-matched reference values. Future studies may compare reproductive hormone levels with case controls.



Future longitudinal studies are necessary to determine whether pretreatment impaired gonadal function at the time of cancer diagnosis is an important determinant of ultimate recovery of spermatogenesis after treatment and later on in adulthood.



W.v.D. was supported by the Pediatric Oncology Center Society for Research (KOCR), Rotterdam, The Netherlands. A.-L.L.F.v.d.K. was supported by EU FP7 PanCare LIFE study. The authors have no conflicts of interest.
Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.
Kiki M G J
KM
Wigny
Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.|Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Erasmus MC-University Medical Center Rotterdam, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
Wendy
W
van Dorp
Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.|Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Erasmus MC-University Medical Center Rotterdam, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
Anne-Lotte L F
AL
van der Kooi
Department of Clinical Chemistry, Erasmus MC-University Medical Center Rotterdam, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
Yolanda B
YB
de Rijke
Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.
Andrica C H
AC
de Vries
Division of Andrology, Department of Urology, Erasmus MC-University Medical Center Rotterdam, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
Marij
M
Smit
Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.
Saskia M F
SM
Pluijm
Division of Pediatric Endocrinology, Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.
Erica L T
EL
van den Akker
Department of Pediatric Oncology, Princess Maxima Center for Pediatric Oncology/Hematology, Lundlaan 6, 3584 EA Utrecht, The Netherlands.
Rob
R
Pieters
Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Erasmus MC-University Medical Center Rotterdam, 's-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands.
Joop S E
JS
Laven
Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands m.m.vandenheuvel-eibrink@prinsesmaximacentrum.nl.|Department of Pediatric Oncology, Princess Maxima Center for Pediatric Oncology/Hematology, Lundlaan 6, 3584 EA Utrecht, The Netherlands.
Marry M
MM
van den Heuvel-Eibrink
D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D006689:Hodgkin Disease / Q000097:blood; D006801:Humans; D007223:Infant; D007265:Inhibins / Q000097:blood*; D007680:Kidney Neoplasms / Q000097:blood; D015470:Leukemia, Myeloid, Acute / Q000097:blood; D008228:Lymphoma, Non-Hodgkin / Q000097:blood; D008297:Male; D009369:Neoplasms / Q000097:blood*; D009447:Neuroblastoma / Q000097:blood; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood; D012509:Sarcoma / Q000097:blood; D013739:Testosterone / Q000097:blood*; D009396:Wilms Tumor / Q000097:blood
C422364:inhibin B; D013739:Testosterone; D007265:Inhibins
Inhibin B; childhood cancer; fertility markers; gonadal function; gonadal impairment; pretreatment; spermatogenesis; testosterone