The effect of testicular irradiation on Leydig cell function in prepubertal boys with acute lymphoblastic leukaemia

Testicular function was investigated by the luteinising hormone releasing hormone (LHRH) test and a three day human chorionic gonadotrophin (HCG) test in 11 prepubertal boys with acute lymphoblastic leukaemia (ALL) who had received 2400 rads of fractionated radiation to their testes after relapse at this site. The results were compared with an unirradiated control group. Basal and peak testosterone values after 1000 units of HCG were significantly lower in the irradiated patients than in the control group. Peak follicle stimulating hormone (FSH) values after 100 micrograms LHRH were significantly higher in irradiated boys, but there was no difference in either basal FSH or basal and peak luteinising hormone values. The findings suggest that the ability of the Leydig cell to produce testosterone--as detected by the HCG test--is appreciably reduced after irradiation and that tubular dysfunction in prepubertal boys may sometimes be predicted by a raised FSH response.