Testicular function after cytotoxic chemotherapy: evidence of Leydig cell insufficiency.

2.50
Hdl Handle:
http://hdl.handle.net/10541/87859
Title:
Testicular function after cytotoxic chemotherapy: evidence of Leydig cell insufficiency.
Authors:
Howell, Simon J; Radford, John A ( 0000-0001-7898-2786 ) ; Ryder, W David J; Shalet, Stephen M
Abstract:
PURPOSE: To evaluate testicular function in men after treatment with cytotoxic chemotherapy. PATIENTS AND METHODS: We measured testosterone, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels in 209 men after treatment with mechlorethamine, vinblastine, procarbazine, and prednisone, hybrid chemotherapy, or high-dose chemotherapy and in 54 healthy age-matched controls. RESULTS: The mean age of the patients was 38 years (range, 19 to 68 years), and all patients had received chemotherapy between 1 and 22 years previously. Patients had significantly higher mean LH (7.9 v 4.1 IU/L; P < .0001) and FSH levels (18.8 v 3.1 IU/L; P < .0001) than controls. There was no significant difference in mean total testosterone level between the patients and controls, but there was a trend toward a lower mean testosterone/SHBG ratio in the patients (0.63 v 0.7; P = .08). Analysis of the hormonal parameters using a model that allowed for the effects of increasing age on testicular function showed evidence of significant recovery of gonadal function in the first 10 years after treatment. Fifty-two percent of patients had LH levels at or above the upper limit of normal, and 32% of patients had increased LH with testosterone levels in the lower half of the normal range, suggesting a degree of Leydig cell impairment. CONCLUSION: In a significant proportion of men, there is good evidence of Leydig cell dysfunction after cytotoxic chemotherapy. The clinical significance of this Leydig cell dysfunction is not clear, but some of these men may benefit from testosterone replacement. Further studies are warranted.
Affiliation:
Department of Endocrinology, Christie Hospital National Health Service Trust, Withington, Manchester, United Kingdom.
Citation:
Testicular function after cytotoxic chemotherapy: evidence of Leydig cell insufficiency. 1999, 17 (5):1493-8 J. Clin. Oncol.
Journal:
Journal of Clinical Oncology
Issue Date:
May-1999
URI:
http://hdl.handle.net/10541/87859
PubMed ID:
10334536
Type:
Article
Language:
en
ISSN:
0732-183X
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorHowell, Simon Jen
dc.contributor.authorRadford, John Aen
dc.contributor.authorRyder, W David Jen
dc.contributor.authorShalet, Stephen Men
dc.date.accessioned2009-12-14T12:54:06Z-
dc.date.available2009-12-14T12:54:06Z-
dc.date.issued1999-05-
dc.identifier.citationTesticular function after cytotoxic chemotherapy: evidence of Leydig cell insufficiency. 1999, 17 (5):1493-8 J. Clin. Oncol.en
dc.identifier.issn0732-183X-
dc.identifier.pmid10334536-
dc.identifier.urihttp://hdl.handle.net/10541/87859-
dc.description.abstractPURPOSE: To evaluate testicular function in men after treatment with cytotoxic chemotherapy. PATIENTS AND METHODS: We measured testosterone, sex hormone-binding globulin (SHBG), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) levels in 209 men after treatment with mechlorethamine, vinblastine, procarbazine, and prednisone, hybrid chemotherapy, or high-dose chemotherapy and in 54 healthy age-matched controls. RESULTS: The mean age of the patients was 38 years (range, 19 to 68 years), and all patients had received chemotherapy between 1 and 22 years previously. Patients had significantly higher mean LH (7.9 v 4.1 IU/L; P < .0001) and FSH levels (18.8 v 3.1 IU/L; P < .0001) than controls. There was no significant difference in mean total testosterone level between the patients and controls, but there was a trend toward a lower mean testosterone/SHBG ratio in the patients (0.63 v 0.7; P = .08). Analysis of the hormonal parameters using a model that allowed for the effects of increasing age on testicular function showed evidence of significant recovery of gonadal function in the first 10 years after treatment. Fifty-two percent of patients had LH levels at or above the upper limit of normal, and 32% of patients had increased LH with testosterone levels in the lower half of the normal range, suggesting a degree of Leydig cell impairment. CONCLUSION: In a significant proportion of men, there is good evidence of Leydig cell dysfunction after cytotoxic chemotherapy. The clinical significance of this Leydig cell dysfunction is not clear, but some of these men may benefit from testosterone replacement. Further studies are warranted.en
dc.language.isoenen
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols-
dc.subject.meshBiological Markers-
dc.subject.meshCase-Control Studies-
dc.subject.meshFollicle Stimulating Hormone-
dc.subject.meshHumans-
dc.subject.meshLeydig Cells-
dc.subject.meshLuteinizing Hormone-
dc.subject.meshMale-
dc.subject.meshMechlorethamine-
dc.subject.meshMiddle Aged-
dc.subject.meshPrednisolone-
dc.subject.meshProcarbazine-
dc.subject.meshReference Values-
dc.subject.meshSex Hormone-Binding Globulin-
dc.subject.meshTestosterone-
dc.subject.meshVinblastine-
dc.titleTesticular function after cytotoxic chemotherapy: evidence of Leydig cell insufficiency.en
dc.typeArticleen
dc.contributor.departmentDepartment of Endocrinology, Christie Hospital National Health Service Trust, Withington, Manchester, United Kingdom.en
dc.identifier.journalJournal of Clinical Oncologyen

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