Return of Normal Testicular Activity in Cured Patients of Lymphoma

Abstract

BACKGROUNDFor young patients cured of lymphoma, the major concern is gonadal dysfunction with impaired reproductive capacity. This has a bearing on the social well-being and self-esteem of these otherwise cured patients. Pretreatment infertility is a significant problem in males having Hodgkin's lymphoma. This already compromised testicular activity further deteriorates with chemotherapy and radiotherapy. Recovery of testicular activity after cure and subsequent cessation of treatment reaches a peak at around 5 years. Further longer follow-up beyond five years has demonstrated varying results of improvement and return of normal testicular activity. AIMTo determine impact of treatment and long-term follow-up on return of normal testicular activity in patients cured of lymphoma. MATERIALS AND METHODSProspective study comprising 30 newly diagnosed male patients with histopathological diagnosis of lymphoma. Semen analysis, serum FSH and LH levels were determined pretreatment, immediately after completion of therapy and yearly till 20 years (From 1994(From -2014. Pretreatment, immediate post-treatment, 5-year and 20-year observations are evaluated for presentation. RESULTSPretreatment infertility was present in 13.47% of patients. After completion of treatment, 77.50% developed azoospermia. However, after initial follow-up of 5 years, percentage of normospermic patients returned to 42.93%, recovery being better in patients of age less than 30 years. Reevaluation of 18 cured patients at a further 20 years follow-up demonstrated no further significant recovery. CONCLUSIONThe effect of cyclophosphamide and procarbazine containing chemotherapy is significant compared to the patients who received combinations without procarbazine. Initial recovery of testicular functions achieved at 5 years was less likely to improve significantly even after a prolonged follow-up period of 20 years. KEYWORDSHodgkin's Lymphoma, Non-Hodgkin's Lymphoma, Semen Analysis, FSH, LH. HOW TO CITE THIS ARTICLE:Kuchay S, Paul ZA, Nabi M. Return of normal testicular activity in cured patients of lymphoma.