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KMID : 0387820020090010021
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Clinical Pediatric Hematology-Oncology
2002 Volume.9 No. 1 p.21 ~ p.29
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Sexual Development and Reproductive Function in Male Adults Treated for Childhood Acute Lymphoblastic Leukemiaor Malignant Lymphoma
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Jang Pil-Sang
Shin Hee-Young
Ahn Hyo-Seop
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Abstract
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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.
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KEYWORD
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Childhood malignancy, Chemotherapy, Sexual development, Repoductive function
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