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Gonadal function in young patients successfully treated for Hodgkin disease
V Papadakis1, E Vlachopapadopoulou, K Van Syckle
1Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Medical and Pediatric Oncology
|April 29, 1999
Summary
Pediatric Hodgkin disease survivors treated with chemotherapy +/- radiation show germ cell dysfunction in males but preserved Leydig cell function. Female survivors often regain normal ovarian function, suggesting early hormone tests may not predict reproductive potential.
Area of Science:
- Oncology
- Endocrinology
- Reproductive Medicine
Background:
- Gonadal function is not well-defined in pediatric and young adult Hodgkin disease survivors.
- This study evaluates outcomes after the Multiple Drug Protocol (MDP).
Purpose of the Study:
- To assess ovarian and testicular function in Hodgkin disease survivors treated with radiation (RT), chemotherapy (CT), or both.
- To compare outcomes with published data.
Main Methods:
- Assessed gonadal function in 65 Hodgkin disease survivors (36 males) in remission.
- Patients received RT, CT (six cycles of MDP), or both.
- Classified patients into three groups based on treatment: RT only, CT only, CT + pelvic RT.
Main Results:
- All patients achieved puberty (Tanner stage IV-V).
- Males: Increased FSH and decreased testicular volume noted in CT groups; Leydig cell function (LH, testosterone) was mostly normal.
- Females: 17% prevalence of ovarian dysfunction; abnormal early hormone levels normalized in some, and six delivered eight children.
Conclusions:
- Most males receiving CT +/- RT exhibit germ cell dysfunction, but Leydig cell function is generally preserved.
- Female survivors often regain normal ovarian function, indicating early hormone tests may not predict long-term reproductive potential.