Review of the Function of the Hypothalamic–Pituitary–Gonadal Axis in Children and Adolescents with Cancer

JIMENA LOPEZ DACAL; ROMINA P GRINSPON; RODOLFO A REY

touchREVIEWS in Endocrinology

Touch Medical Media

Año: 2022 vol. 17 p. 122 - 132

2752-5457

The most common malignancies in childhood are leukaemias, brain tumours, lymphomas, neuroblastomas, soft tissue sarcomas andkidney tumours. At present, about 80% of childhood cancers can be treated successfully, which has significantly increased long-termsurvival. Concomitantly, adult gonadal function in childhood cancer survivors has become a concern. However, the immediate effectof cancer and its management on the reproductive axis function has received less attention. We conducted a review of the effects ofmalignancies and their treatments on the gonadal axis during childhood and adolescence. Some results are controversial, probably becausethe analyses do not distinguish between the malignancy types, their treatments and/or the age at treatment. However, there is agreementthat cancer can partially affect gonadal function before treatment, as revealed by low circulating levels of inhibin B and anti-Müllerianhormone. Subsequently, chemotherapy transiently impairs the somatic component of the gonads (i.e. testicular Sertoli cells and ovariangranulosa cells) with normalization after treatment ends. The impact of chemotherapy may persist through adulthood after more intensivechemotherapy regimens, radiotherapy and conditioning for haematopoietic stem cell transplantation, when there is a severe impairment ofthe somatic component of the gonads or of the stem germ cells.