Effect of chemotherapy on endocrine testicular function during childhood and puberty in patients with acute lymphoblastic leukaemia or non-Hodgkin lymphoma: a prospective, longitudinal study

BRENZONI; GUTIERREZ M.; REY RA; PRADA S; BEDECARRÁS , PATRICIA; GRINSPON R P; AROZARENA DE GAMBOA, MARIA; AVERSA L

Buenos Aires

Congreso; SAIC; 2020

Introduction: Chemotherapy can have variable effects according to the proliferative state of cell populations. Testicular Sertoli cells show differences in proliferative status between infancy and puberty.Aim: To determine if there is a differential effect of chemotherapy on Sertoli cell function between children and adolescents with hematologic malignancies during and after treatment. Secondarily, testosterone and gonadotropins was evaluated.Methods: prospective cohort study in children with acute lymphoblastic leukaemia or non-Hodgkin lymphoma. Serum levels of AMH and FSH (direct and indirect marker of Sertoli cells, respectively) and of testosterone (T) and LH (direct and indirect markers of Leydig cells) were evaluated during chemotherapy and for 24 months after the end of the treatment. Results were analysed according to pubertal stage and expressed as median (range).Results: 16 prepubertal boys, age 4.2 yr (0.7-7.1), and 5 pubertal, age 13.4 yr (11.7-14.8) were analysed. Follow-up was 4.6 ± 0.6 years. In prepubertal boys, AMH was pre-treatment (tx): 709 pmol/L (331-1333), at 3 months (m) of tx: 1191 (396-1660), 6 m: 934 (273-1325), 12 m: 577 (338-1474), 24 m (end tx): 1156 (625-1563); in the subsequent follow-up, 3 m: 1096 (532-1708), 12 m: 1212 (603-2601) and 24 m: 1011 (520-2035). 24 m after end of tx, serum AMH was higher than baseline in all patients. T, FSH and LH were always normal. In pubertal boys, AMH was pre-tx 74 pmol/L (39-121), 3 m: 76 (47-98), 6 m: 92 (64-173), 12 m: 74 (55-229), 24 m (end tx): 95 (46-118); in follow-up: 3 m: 124 (37-174), 12 m: 140 (76-157) and 24 m: 129 (32-173). T was always normal. FSH and LH increased during chemotherapy and normalised 24 m after the end of chemotherapy.Conclusion: In prepubertal boys, no compromise of Sertoli cell function was observed during the entire follow-up. In pubertal boys, a transient elevation of gonadotropins was observed, which may reflect a reversible deleterious effect of chemotherapy.