Gonadal function following chemotherapy for childhood Hodgkin's disease

Mackie, Eleanor J.; Radford, Mike; Shalet, Stephen M

doi:10.1002/(sici)1096-911x(199608)27:2<74::aid-mpo2>3.0.co;2-q

Cited by 207 publications

(118 citation statements)

References 23 publications

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“…It is interesting to note that early puberty is often reported, particularly in females treated with cranial radiation doses of < 24 Gy. 14 However, it has been shown that after lowdose cranial radiotherapy (18)(19)(20)(21)(22)(23)(24), there is a subtle decline in hypothalamic-pituitary-ovarian function as characterized by decreased luteinizing hormone (LH) secretion, an attenuated LH surge, and shorter luteal phases that are likely to herald incipient ovarian failure or be associated with early pregnancy loss. 15 …”

Section: Radiation and The Hypothalamic-pituitaryovarian Axismentioning

confidence: 99%

“…Although these drug combinations have resulted in excellent survival rates, the majority of male patients have subsequently developed permanent azoospermia. 36,37 Mackie et al 19 studied patients with a mean age at diagnosis of 12.2 years who were treated with ChLVPP, a regimen containing both chlorambucil and procarbazine. On follow-up, 89% of these patients demonstrated severe damage to the seminiferous epithelium up to 10 years after therapy.…”

Section: The Effect Of Radiotherapy On Testicular Functionmentioning

confidence: 99%

“…Because of this, treatment for HL has been modified in an attempt to reduce gonadotoxicity while maintaining long-term survival. 19 Treatment with the ABVD regimen, which contains no alkylating agents or procarbazine, results in significantly less gonadotoxicity, with no patients demonstrating permanent azoospermia. 36 However, anthracycline exposure in this regimen renders it potentially cardiotoxic in the long term.…”

Section: The Effect Of Radiotherapy On Testicular Functionmentioning

confidence: 99%

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Oncofertility and preservation of reproductive capacity in children and young adults

Wallace

2011

Cancer

170

114

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With increasing numbers of survivors from cancer at a young age, the issue of fertility preservation has assumed greater importance. This review describes normal ovarian and testicular function and summarizes what is known about the effect of chemotherapy and radiotherapy on the gonads and uterus. All young patients with cancer or leukemia should have their fertility prognosis discussed before the initiation of treatment. Sperm and embryo cryopreservation should be considered standard practice and be widely available for those at significant risk of infertility. For prepubertal girls, ovarian tissue cryopreservation should be considered if the risk of premature menopause is high, but for the prepubertal boy there are no established techniques in current practice. Cancer 2011;117(10 suppl):2301–10. © 2011 American Cancer Society.

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Section: Radiation and The Hypothalamic-pituitaryovarian Axismentioning

confidence: 99%

Section: The Effect Of Radiotherapy On Testicular Functionmentioning

confidence: 99%

Section: The Effect Of Radiotherapy On Testicular Functionmentioning

confidence: 99%

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Oncofertility and preservation of reproductive capacity in children and young adults

Wallace

2011

Cancer

170

114

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“…Several studies have shown an impaired gonadal function in adult male survivors of childhood cancer [4,5]. Post-treatment gonadal damage showed to be depending on the type of used agents and cumulative dosages administered during childhood [6][7][8]. Usually, studies were based on one type of malignancy and treatment protocol and had limited number of survivors included [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…Post-treatment gonadal damage showed to be depending on the type of used agents and cumulative dosages administered during childhood [6][7][8]. Usually, studies were based on one type of malignancy and treatment protocol and had limited number of survivors included [6][7][8]. Age at time of treatment was suggested to give some protection against chemotherapy induced gonadal damage due to quiescent stage of the testis in the prepubertal age [9].…”

Section: Introductionmentioning

confidence: 99%

Effect of childhood cancer treatment on fertility markers in adult male long‐term survivors

Casteren

Linden

Hakvoort-Cammel

et al. 2008

Pediatric Blood & Cancer

127

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BackgroundAlthough it is accepted that pediatric cancer treatment harbors a risk of gonadal damage, large cohort studies using up‐to‐date fertility markers are lacking.ProcedureThe aim of our study was to evaluate the gonadal toxicity of childhood cancer treatment using fertility markers. We included 248 adult male long‐term survivors of childhood cancer. Median age at diagnosis: 5 years, median age at follow‐up: 24 years, median follow‐up time 18 years. We evaluated patient characteristics, treatment modalities, testicular size, and endocrinological parameters including Inhibin B, luteinizing hormone (LH), follicle‐stimulating hormone (FSH), and testosterone.ResultsThe median value of Inhibin B in the cancer survivor group was 126 ng/L versus 177 ng/L in the control group (P < 0.001). In the survivors, 67% had Inhibin B levels below the normal reference value of 150 ng/L compared with 26% in the control group (P < 0.05). Inhibin B was the most sensitive discriminator between survivors and controls. Significantly decreased Inhibin B levels and increased FSH levels were found in men treated for Hodgkin and non‐Hodgkin lymphoma, acute‐myeloid leukemia, neuroblastoma, and sarcoma as compared to other malignancies. Cumulative dosages of procarbazine and cyclophosphamide were the only independent chemotherapy‐related predictors for decrease of Inhibin B levels and increase of FSH. Age at time of treatment did not influence post‐treatment Inhibin B or FSH levels.ConclusionsSevere gonadal impairment is a risk in a considerable subgroup of childhood cancer survivors based on current fertility markers like Inhibin B. Males receiving gonadotoxic treatment before puberty are not protected from post treatment gonadal dysfunction. Pediatr Blood Cancer 2009;52:108–112. © 2008 Wiley‐Liss, Inc.

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High incidence of treatment failure with vincristine, etoposide, epirubicin, and prednisolone chemotherapy with successful salvage in childhood Hodgkin disease

Ekert

Toogood

Downie

et al. 1999

Med. Pediatr. Oncol.

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Background and Procedure In an attempt to further reduce the long‐term toxicity of chemotherapy for childhood Hodgkin disease (HD), the Australian and New Zealand Children's Cancer Study Group between 1990 and 1996 enrolled 53 children with biopsy‐proven and imaging‐staged HD into a chemotherapy‐only treatment regimen using 5–6 courses of vincristine, etoposide, epirubicin, and prednisolone (VEEP). Results There were 23 events in these children with 3 progressive disease (PD), 8 partial remissions (PR), and 12 relapses. In the stage I patients, there were 8 events (35%). There was no association between the number of events and the stage of HD. Massive mediastinal disease at diagnosis was present in 16 patients, 11 of whom had an event with 3 PD, 3 PR, and 5 relapses. For all patients with an event at 6–24‐month follow‐up, all but two patients were salvaged with either alkylating agent‐based chemotherapy alone or with irradiation and chemotherapy. The event‐free survival for the whole group with median follow‐up of 33 months was 59%, but only 31% for massive mediastinal disease. Disease‐free survival was 78% and overall survival at 60 months was 92%, with one death due to drug‐induced aplasia and another from acute myeloid leukemia. Conclusions We conclude that VEEP chemotherapy in childhood HD used as the only treatment modality has an unacceptably high treatment failure rate in patients with massive mediastinal disease and 35% incidence of treatment failure in stage I disease. Med. Pediatr. Oncol. 32:255–258, 1999. © 1999 Wiley‐Liss, Inc.

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Gonadal function following chemotherapy for childhood Hodgkin's disease

Cited by 207 publications

References 23 publications

Oncofertility and preservation of reproductive capacity in children and young adults

Oncofertility and preservation of reproductive capacity in children and young adults

Effect of childhood cancer treatment on fertility markers in adult male long‐term survivors

High incidence of treatment failure with vincristine, etoposide, epirubicin, and prednisolone chemotherapy with successful salvage in childhood Hodgkin disease

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