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The influence of different intensity of treatment on hormonal markers of gonadal function in acute lymphoblastic leukemia survivors
Author(s) -
KrawczukRybak Maryna,
Płonowski Marcin,
Leszczyńska Elżbieta,
Latoch Eryk,
SawickaŻukowska Małgorzata,
MuszyńskaRosłan Katarzyna,
SkalskaSadowska Jolanta,
Wachowiak Jacek,
SgaPondel Dorota,
Kazanowska Bernarda,
Chybicka Alicja,
StachowiczStencel Teresa,
Stefanowicz Joanna,
Malinowska Iwona,
Matysiak Michał,
Kotan Andrzej,
Wysocki Mariusz,
PobudejskaPieniążek Aneta,
Szczepański Teresa,
Przybyszewski Borys,
Badowska Wanda,
SzymańskaMiller Dorota,
Kowalczyk Jerzy R.,
Kamieńska Elżbieta,
Urasiński Tomasz,
Wawrzeńczyk Anna,
ŻelazowskaRutkowska Beata,
Cylwik Bogdan
Publication year - 2019
Publication title -
hematological oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 44
eISSN - 1099-1069
pISSN - 0278-0232
DOI - 10.1002/hon.2681
Subject(s) - hormone , testosterone (patch) , luteinizing hormone , medicine , endocrinology , follicular phase , follicle stimulating hormone , anti müllerian hormone , ovarian reserve , total body irradiation , physiology , chemotherapy , cyclophosphamide , biology , infertility , pregnancy , genetics
Anti‐cancer treatment in children can deteriorate gonadal function and affect future fertility. We analyzed the hormonal markers of gonadal function in adolescent leukemia survivors, treated in childhood with different levels of aggressiveness. We analyzed hormone levels in 69 adolescents and young adults, leukemia survivors stratified into standard (SR), intermediate (IR), and high (HR) risk groups, and in 80 healthy controls (38 men) at a similar age. We assessed follicular stimulating hormone (FSH), luteinizing hormone (LH), and inhibin B in the whole group, testosterone in males, and E2 and anti‐Müllerian hormone (AMH) in females. Males classified into HR group presented, in comparison to control, higher levels of FSH, LH, lower inhibin B, and normal testosterone, whereas in SR and IR group, the hormonal values were comparable to the control. In females, in all risk groups, the levels of FSH, LH, E2, and inhibin B were comparable with the control, but the mean AMH levels were slightly lowered. We did not observe the effect of prophylactic cranial irradiation (12 or 18 Gy) or the time of treatment (before vs. during puberty) on hormone levels. In females, a positive correlation was found between the time interval after the end of treatment and AMH levels. Male leukemia survivors having undergone more intensive chemotherapy show the symptoms of disturbed spermatogenesis and need to be followed‐up in the future. Women, irrespective of the risk group, can develop the signs of preterm ovarian insufficiency. They should be informed about the impact of the treatment on gonadal function.