Gonadal function after combination chemotherapy for XXXX in childhood.

@entity4174 @entity16 @entity1891 @entity3893 @entity342 @entity3700 @entity617 @entity978
The effect of quadruple chemotherapy ( @entity3700 , @entity1891 , @entity4174 , and @entity617 ) on gonadal function was investigated in 15 males and 2 females treated for @entity978 during childhood. The 2 females have regular menstrual cycles with evidence of ovulation in one. Twelve of the males have shown normal progression of pubertal development since completing their treatment. Nine out of 10 late pubertal or adult subjects had small testes but only one developed gynaecomastia. All 4 prepubertal subjects had normal basal and peak gonadotrophin responses to luteinising hormone-releasing hormone. Nine of the 12 subjects studied during puberty or adulthood had either an increased basal serum follicle-stimulating hormone (FSH) level or an exaggerated FSH response to luteinising hormone-releasing hormone. Each of the 6 males who provided semen for analysis was azoospermic after an interval of between 2.4 and 8 (mean 5.3) years after completion of treatment. We conclude that severe @entity16 is common after treatment with @entity3700 , @entity1891 , @entity4174 , and @entity617 in childhood. The germinal epithelium is particularly vulnerable and the resultant @entity3893 is likely to be irreversible. The Leydig cells are less susceptible to cytotoxic-induced damage. Pubertal development is normal and there is no indication for @entity342 replacement therapy.
