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dc.contributor.authorClark, S Ten
dc.contributor.authorRadford, John Aen
dc.contributor.authorCrowther, Dereken
dc.contributor.authorSwindell, Ricen
dc.contributor.authorShalet, Stephen Men
dc.date.accessioned2010-05-17T15:22:18Z
dc.date.available2010-05-17T15:22:18Z
dc.date.issued1995-01
dc.identifier.citationGonadal function following chemotherapy for Hodgkin's disease: a comparative study of MVPP and a seven-drug hybrid regimen. 1995, 13 (1):134-9 J. Clin. Oncol.en
dc.identifier.issn0732-183X
dc.identifier.pmid7799013
dc.identifier.urihttp://hdl.handle.net/10541/99001
dc.description.abstractPURPOSE AND METHODS: Gonadal function was assessed in 89 patients after chemotherapy for Hodgkin's disease (HD). Thirty-seven patients had received mechlorethamine, vinblastine, prednisolone, and procarbazine (MVPP) and 52 patients, a hybrid combination of chlorambucil, vinblastine, prednisolone, procarbazine, doxorubicin, vincristine, and etoposide (ChIVPP/EVA). Fifty men (MVPP, n = 21; ChIVPP/EVA, n = 29) with a median age of 26 years (range, 16 to 54) and 39 women (MVPP, n = 16; ChIVPP/EVA, n = 23) with a median age of 30 years (range, 15 to 47) were studied at a median of 30 months (range, 4 to 83) following chemotherapy. RESULTS: Semen analysis showed azoospermia in 35 of 37 men, and increased serum follicle-stimulating hormone (FSH) levels in this group confirmed severe germinal epithelial damage. Analysis of pretreatment semen in 28 men showed azoospermia in one, oligospermia in four (sperm count < 20 x 10(6)/mL), and a normal sperm count in the remaining 23. In the women, 26 of 34 (76%) with a regular menstrual cycle before commencing chemotherapy became amenorrheic following treatment. Menses returned in 10 women, who had a median age of 25 years (range, 21 to 34), and there were two pregnancies in this group. In the other 16, with a median age of 36 years (range, 27 to 47), amenorrhea persisted and premature ovarian failure was confirmed by increased serum gonadotrophins and reduced estradiol (E2) concentrations. Of the original eight women in whom menses were maintained following treatment, two subsequently developed amenorrhea and the clinical and biochemical features of an early menopause. In total, 18 of 34 women (53%) required hormone replacement therapy for chemotherapy-induced ovarian failure. CONCLUSION: There was no statistically significant difference in the frequency or severity of gonadal dysfunction between MVPP- and ChIVPP/EVA-treated patients. We conclude that both of these chemotherapy schedules cause substantial damage to gonadal function in both sexes.
dc.language.isoenen
dc.subject.meshAdolescent
dc.subject.meshAdult
dc.subject.meshAmenorrhea
dc.subject.meshAntineoplastic Combined Chemotherapy Protocols
dc.subject.meshChlorambucil
dc.subject.meshDoxorubicin
dc.subject.meshEtoposide
dc.subject.meshFemale
dc.subject.meshFollicle Stimulating Hormone
dc.subject.meshHodgkin Disease
dc.subject.meshHumans
dc.subject.meshLibido
dc.subject.meshLuteinizing Hormone
dc.subject.meshMale
dc.subject.meshMechlorethamine
dc.subject.meshMenstrual Cycle
dc.subject.meshMiddle Aged
dc.subject.meshOvarian Failure, Premature
dc.subject.meshPrednisolone
dc.subject.meshProcarbazine
dc.subject.meshProspective Studies
dc.subject.meshSemen
dc.subject.meshSex Hormone-Binding Globulin
dc.subject.meshSperm Count
dc.subject.meshTestis
dc.subject.meshTestosterone
dc.subject.meshVinblastine
dc.subject.meshVincristine
dc.titleGonadal function following chemotherapy for Hodgkin's disease: a comparative study of MVPP and a seven-drug hybrid regimen.en
dc.typeArticleen
dc.contributor.departmentDepartment of Endocrinology, Christie Hospital National Health Service Trust, Manchester, United Kingdom.en
dc.identifier.journalJournal of Clinical Oncologyen
html.description.abstractPURPOSE AND METHODS: Gonadal function was assessed in 89 patients after chemotherapy for Hodgkin's disease (HD). Thirty-seven patients had received mechlorethamine, vinblastine, prednisolone, and procarbazine (MVPP) and 52 patients, a hybrid combination of chlorambucil, vinblastine, prednisolone, procarbazine, doxorubicin, vincristine, and etoposide (ChIVPP/EVA). Fifty men (MVPP, n = 21; ChIVPP/EVA, n = 29) with a median age of 26 years (range, 16 to 54) and 39 women (MVPP, n = 16; ChIVPP/EVA, n = 23) with a median age of 30 years (range, 15 to 47) were studied at a median of 30 months (range, 4 to 83) following chemotherapy. RESULTS: Semen analysis showed azoospermia in 35 of 37 men, and increased serum follicle-stimulating hormone (FSH) levels in this group confirmed severe germinal epithelial damage. Analysis of pretreatment semen in 28 men showed azoospermia in one, oligospermia in four (sperm count < 20 x 10(6)/mL), and a normal sperm count in the remaining 23. In the women, 26 of 34 (76%) with a regular menstrual cycle before commencing chemotherapy became amenorrheic following treatment. Menses returned in 10 women, who had a median age of 25 years (range, 21 to 34), and there were two pregnancies in this group. In the other 16, with a median age of 36 years (range, 27 to 47), amenorrhea persisted and premature ovarian failure was confirmed by increased serum gonadotrophins and reduced estradiol (E2) concentrations. Of the original eight women in whom menses were maintained following treatment, two subsequently developed amenorrhea and the clinical and biochemical features of an early menopause. In total, 18 of 34 women (53%) required hormone replacement therapy for chemotherapy-induced ovarian failure. CONCLUSION: There was no statistically significant difference in the frequency or severity of gonadal dysfunction between MVPP- and ChIVPP/EVA-treated patients. We conclude that both of these chemotherapy schedules cause substantial damage to gonadal function in both sexes.


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