The influence of different intensity of treatment on hormonal markers of gonadal function in acute lymphoblastic leukemia survivors

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...

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Published in:	Hematological oncology Vol. 37; no. 5; pp. 609 - 616
Main Authors:	Krawczuk‐Rybak, Maryna, Płonowski, Marcin, Leszczyńska, Elżbieta, Latoch, Eryk, Sawicka‐Żukowska, Małgorzata, Muszyńska‐Rosłan, Katarzyna, Skalska‐Sadowska, Jolanta, Wachowiak, Jacek, Sga‐Pondel, Dorota, Kazanowska, Bernarda, Chybicka, Alicja, Stachowicz‐Stencel, Teresa, Stefanowicz, Joanna, Malinowska, Iwona, Matysiak, Michał, Kotan, Andrzej, Wysocki, Mariusz, Pobudejska‐Pieniążek, Aneta, Szczepański, Teresa, Przybyszewski, Borys, Badowska, Wanda, Szymańska‐Miller, Dorota, Kowalczyk, Jerzy R., Kamieńska, Elżbieta, Urasiński, Tomasz, Wawrzeńczyk, Anna, Żelazowska‐Rutkowska, Beata, Cylwik, Bogdan
Format:	Journal Article
Language:	English
Published:	England Wiley Subscription Services, Inc 01-12-2019
Subjects:	Acute lymphoblastic leukemia Adolescent Adolescents anti‐Müllerian hormone Biomarkers Cancer Survivors Chemotherapy Child Child, Preschool childhood cancer survivors Children Combined Modality Therapy - adverse effects Combined Modality Therapy - methods Female Females Fertility Follicle-stimulating hormone Follow-Up Studies gonadal function Gonadal Steroid Hormones - blood Gonads - metabolism Humans Inhibin inhibin B Irradiation late effect Leukemia Luteinizing hormone Lymphatic leukemia Male Males Markers Men Precursor Cell Lymphoblastic Leukemia-Lymphoma - blood Precursor Cell Lymphoblastic Leukemia-Lymphoma - diagnosis Precursor Cell Lymphoblastic Leukemia-Lymphoma - therapy Puberty Risk Risk groups Spermatogenesis Survival Testosterone Young adults anti-Müllerian hormone childhood cancer survivors inhibin B late effect gonadal function fertility
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Summary:	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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0278-0232 1099-1069
DOI:	10.1002/hon.2681