[Preliminary results of reproductive system function assessment in young men after Hodgkin's disease therapy]

The introduction of modern methods of combined therapy: chemotherapy and radiotherapy, allows the cure more than 90% of children and adolescents with Hodgkin's disease (HD). However, the intensive treatment carries the risk of early and late complications. One of the late effects is gonadal dysfunction which may develop in men as well as in women. In this report preliminary results of testicular function assessment in young men after HD therapy. Testicular function was evaluated in 24 young men (age: 10.6-18.2 years, median 14.6 years at the beginning of treatment, and 18.5-24.6 years, median 21.4 years at the end of therapy) treated between January 1, 1999 and December 31, 2009. in Department of Pediatric Oncology and Hematology PAIP JU-CM in Kraków, according to PGP-HD-97 protocol. Multidrug chemotherapy combined with low-dose involved-field radiotherapy (15-25 Gy) was used in treatment in 21 men, and 3 other men were treated with chemotherapy only. Therapy was completed in all analyzed patients. Physical examination and Tanner stages of pubic hair and genital development were recorded as well as the plasma levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone (TST) were measured in all patients. Testicular volumes were measured in 14 men. The study was conducted between January 1, 2009 and December 31, 2009. All men reached Tanner stages of pubic hair and genital development appropriate for their age. One hundred and fourteen measurements of hormones levels were performed in all of patients. At least one abnormal result of measurements was found in 16/24 (66.7%) of men. The most frequent abnormality was the increased level of FSH (in 15 patients, 60.5% of FSH measurements). Abnormal results of measurements were found in 14/20 (70%) patients who received 6 chemotherapy cycles and in 2/4 patients treated with 3-4 cycles. Within the group of patients with abnormal results eight men previously received subdiaphragmatic region radiotherapy. Semen analysis was performed in one man and revealed azoospermia. Initial results of reproductive system assessment indicate the impairment of testicular function depending on intensity of treatment. Further observation and repeated gonadal function tests (including semen analysis) are needed in young men with completed HD treatment. These studies are essential especially for young people who intend to have children.