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Gonadal function in boys with newly diagnosed cancer before the start of treatment
Kiki M G J Wigny1, Wendy van Dorp1,2, Anne-Lotte L F van der Kooi1,2
1Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands.
Study Question:
Are Inhibin B and testosterone levels reduced in boys with newly diagnosed cancer prior to therapy?
Summary Answer:
Pretreatment serum levels of Inhibin B and testosterone are significantly reduced in boys with newly diagnosed cancer, compared to reference values.
What Is Already Known:
Disease-related gonadal impairment has been demonstrated in girls and young women diagnosed with cancer, prior to therapy.
Study Design, Size, Duration:
We conducted a descriptive study in boys newly diagnosed with cancer between January 2006 and February 2014.
Participants/Materials, Setting, Methods:
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.
Main Results And The Role Of Chance:
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.
Limitations, Reasons For Caution:
In this study, reproductive hormone levels were compared with age-matched reference values. Future studies may compare reproductive hormone levels with case controls.
Wider Implications Of The Findings:
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.
Study Funding/Competing Interests:
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.
Insights
Newly diagnosed cancer in boys is linked to significantly reduced Inhibin B and testosterone levels before treatment. This suggests potential gonadal impairment in young male cancer patients prior to therapy.
Area of Science:
- Pediatric Oncology
- Reproductive Endocrinology
- Cancer Research
Background:
- Disease-related gonadal impairment is known in female cancer patients before therapy.
- Limited data exists on gonadal function in prepubertal and pubertal boys with newly diagnosed cancer.
Purpose of the Study:
- To investigate serum Inhibin B and testosterone levels in boys with newly diagnosed cancer before treatment.
- To compare these hormone levels with age-matched reference values.
Main Methods:
- A descriptive study was conducted on 224 boys (up to 18 years) with newly diagnosed cancer.
- Serum Inhibin B and testosterone levels were measured prior to therapy.
- Hormone levels were compared to reference values.
Main Results:
- Significantly reduced serum Inhibin B levels were observed in boys with cancer (SDS -0.9, P < 0.001).
- A majority of patients (78.6%) had Inhibin B levels below the 50th percentile.
- Serum testosterone levels were also significantly lower than reference ranges (SDS -1.2, P < 0.001).
Conclusions:
- Pretreatment serum Inhibin B and testosterone levels are significantly reduced in boys with newly diagnosed cancer.
- This finding indicates potential gonadal impairment in this population prior to cancer therapy.
- Further longitudinal studies are needed to assess the impact on spermatogenesis recovery.
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