Korean J Pediatr Hematol Oncol.  2002 Apr;9(1):21-29.

Sexual Development and Reproductive Function in Male Adults Treated for Childhood Acute Lymphoblastic Leukemia or Malignant Lymphoma

• Jang PS
• Shin HY
• Ahn HS

Abstract

PURPOSE: As the survival rate of children with malignancies has increased over past decades, the follow-up in adult long-term survivors of childhood malignancies should focus on late effects of disease and treatment. This study was undertaken to find out whether sexual development was affected by the previous chemotherapy and reproductive function could be evaluated by Tanner stage and serum sex hormone level.
METHODS
Pubertal stage and gonadal function were studied in 15 male adults survived 4.3~14.3 years after treatment for acute lymphoblastic leukemia, malignant lymphoma or lymphoma-leukemia during childhood or adolescence.
RESULTS
All patients showed more than stage IV sexual maturity rating. Patients treated with cyclophosphamide including maintenance (CY group) had lesser testicular volume (P=.0001). All patients except one who has testicular involvement at diagnosis, showed normal follicle-stimulating hormone, leutenizing hormone, and testosterone level. Semen analysis was done in 2 patients. One patient with Non-CY group showed normal, whereas one with CY group showed azoospermia. It seemed that treatment period (before or during puberty) or prophylactic cranial radiation therapy did not affect sexual development.
CONCLUSION
Previous chemotherapy did not affect sexual development. Physical examination, sex hormone level, bone age were not sufficient for detecting reproductive impairment. Semen analysis and GnRH or hCG hormone stimulation test should be done in high risk patients treated with chemotherapeutic agents affecting germ cell function or testicular radiation therapy.

Keyword

Childhood malignancy; Chemotherapy; Sexual development; Reproductive function

MeSH Terms

Adolescent
Adult*
Azoospermia
Child
Cyclophosphamide
Diagnosis
Drug Therapy
Follicle Stimulating Hormone
Follow-Up Studies
Germ Cells
Gonadotropin-Releasing Hormone
Gonads
Humans
Lymphoma*
Male*
Physical Examination
Precursor Cell Lymphoblastic Leukemia-Lymphoma*
Semen Analysis
Sexual Development*
Survival Rate
Survivors
Testosterone
Cyclophosphamide
Follicle Stimulating Hormone
Gonadotropin-Releasing Hormone
Testosterone