BACKGROUND: Hodgkin’s lymphoma (HL) is one of the most common malignant lymphoproliferative diseases. Chemotherapy and radiotherapy used in the treatment of LH induce a number of toxic effects leading to dysfunction of endocrine system. Hormonal disorders in HL and their relationships with the therapy used remain to be clarified.AIM: To assess disorders of the endocrine function of thyroid, parathyroid glands and gonads in HL survivors.MATERIALS AND METHODS: Screening of endocrine dysfunction of the thyroid, parathyroid glands and gonads was performed in 160 adult patients with HL, 55 men and 105 women, at remission stage induced by chemotherapy or chemoradiotherapy. Forty healthy subjects, matched by age, were acted as control. The levels of TSH, T3, free T4, PTH, FSH, LH, free testosterone, dehydroepiandrosterone sulfate (DHEA-S), and sex-hormone binding globulin (SHBG) were measured in blood serum by ELISA. Bone mineral density (BMD) was assessed by DEXA.RESULTS: Hypothyroidism (25%), hyperparathyroidism (15.6%) and hypogonadism (29% of men and 25.3% of women) were the most prevalent endocrine disorders in LH survivors. Hypothyroidism was significantly more common in patients after chemoradiotherapy than in those who received only chemotherapy (χ2=9.4, р=0.002). In patients with hyperparathyroidism, there were negative correlations between PTH levels and BMD in the lumbar spine (r=-0.74, p=0.00002) and in the femoral neck (r=-0.66, p=0.0003). Men with HL demonstrated lower free testosterone concentrations when compared to control (p=0.04); LH and FSH levels were elevated (p=0.0004 and p=0.04, respectively). In men with HL the levels of DHEA-S were reduced (p=0.0009). The increased SHBG concentrations were revealed in 13 (23.6%) men. Women of reproductive age with HL had higher levels of LH in the luteal phase (p=0.05) and FSH in the follicular phase (p=0.02) than controls.CONCLUSION: The data indicate a high prevalence of the dysfunctions of thyroid, parathyroid glands, and gonads in HL survivors. Screening for endocrine disorders in these patients is highly recommended.

Introduction. An advance in understanding the biology of Hodgkin’s lymphoma (HL) and improved approaches to anticancer therapy of HL allowed increasing the survival of patients at all stages of the disease. Thus, the 5-year overall survival is more than 85% even in HL patients with III–IV stages. However, early complications and long-term effects of combined chemoradiotherapy remain an urgent problem, reducing the quality of life of patients. Aim. To assess the quality of life of patients with HL in different periods of the disease: at the time of diagnosis of the tumor process and after multiagent chemotherapy programs. Materials and methods. The study included 46 patients with newly diagnosed HL, hospitalized in the Hematology Departments of the City Clinical Hospital No. 2 and the Novosibirsk Regional Clinical Hospital. The control group was represented by 46 apparently healthy people without a tumor process or exacerbation of chronic diseases. The SF-36 Health Survey was used as a tool for assessing the quality of life. Results. The quality of life of patients was significantly higher in patients at onset of the disease than after specific anticancer therapy. Compared with the control group, in patients with HL, both before the start of treatment and after chemoradiotherapy, a deterioration in the physical condition affecting daily activities was noted. Also, with an increase in the in the number of courses of anticancer therapy, the emotional and physical health of patients with HL worsened significantly, and the intensity of pain syndrome was higher in patients with advanced stages of the disease. Conclusion. Currently, the assessment of the quality of life in patients with hematologic malignancies at onset of the disease and after anticancer therapy can help achieve optimal therapy results while maintaining a high level of quality of life.

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