Sertoli cell function is not significantly affected by chemotherapy in boys with acute lymphoblastic leukemia or lymphoblastic lymphoma.

GRINSPON, R.; PRADA, S.; SANZONE, M.; BEDECARRÁS, P.; GIL, G.; GUTIÉRREZ, M.; MORALES, M.; GOTTLIEB, S.; BERGADÁ, I.; AVERSA, L.; REY, R.

Playa del Carmen

Congreso; XXIV Reunión de la Sociedad Latinoamericana de Endocrinología Pediátrica; 2014

SLEP

Sertoli cell function is not significantly affected by chemotherapy in boys with acute lymphoblastic leukemia or lymphoblastic lymphoma. Introduction: Testicular germ cells are highly sensitive to chemotherapy, while precursors of Leydig cells in prepubertal boys seem less affected. However, it is not known yet if chemotherapy affects Sertoli cells, whose function is essential for normal pubertal and adult spermatogenesis. The objective of this work is to evaluate the function of the Sertoli cell in children and adolescent survivors of acute lymphoblastic leukemia (ALL) or lymphoblastic lymphoma who received chemotherapy. Study design and Methods: We performed a retrospective cross-sectional study of male survivors of ALL or lymphoblastic lymphoma treated with chemotherapy at Ricardo Gutiérrez Children?s Hospital between 2004 and 2012. We excluded those who had incomplete laboratory results or ALL relapse. Patients were classified according to the baseline risk (high, intermediate or standard) that determined the chemotherapy protocol used. The main outcome measure was serum AMH. Results were expressed as median and range of SDS according to published reference values themselves . Secondarily, FSH values were analyzed as an indirect Sertoli cell marker. Results: Out of 55 children (LLA: 52 and lymphoblastic lymphoma: 3), 18 had standard risk, 30 intermediate risk and 7 high risk. Age at start of chemotherapy was 6.7 years (1.8 to 16.7). Treatment duration was 2.2 years (range 0.8 to 3.3). 31 patients completed treatment before the age of 10 years and 24 after the age of 10 years. Last hormonal evaluation was 3.0 years (1.1 to 12.1) after treatment. Within the first year after termination of chemotherapy, 29 patients were evaluated; AMH concentration was at -0.09 SDS (-1.31 to 4.92). Between the 2nd and 6th year, 30 patients were evaluated; AMH was at -0.36 SDS (-1.07 to 1.66). In 13 patients evaluated 6 to 12 years after chemotherapy completion AMH was at -0.56 SDS (-1.24 to -1.45). Differences between the three time periods of evaluation were not significant, and no patient had a concentration of AMH 97th centile. All patients with high FSH were older than 11 years of age. AMH levels in these patients was at -0.48 SDS (-1.24 to 1.45). Conclusion: Sertoli cell population was not damaged in children with ALL or lymphoblastic lymphoma who received chemotherapy. This result provides insight for conservation of germ cells in boys submitted to chemotherapy, since the procedure requires a Sertoli cell population with appropriate function for normal spermatogenesis to be reestablished