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Post-Transplant Complications

Patterns of Leydig cell insufficiency in adult males following bone marrow transplantation for haematological malignancies

Bone Marrow Transplantation volume 28, pages 497–502 (2001)Cite this article

Abstract

Gonadal and sexual function are key to quality of life following bone marrow transplantation (BMT), but no large studies have been published on Leydig cell (LC) function in adults. LC insufficiency (LCI) can cause premature andropause with its consequences including sexual morbidity from diminished libido and erectile dysfunction (ED). In addition, LCI can result in generalised fatigue and even osteopenia. We reviewed gonadal function pre-transplant (immediately prior to BMT) and at 3–18 months post BMT in 117 patients who underwent BMT for a variety of haematological malignancies. The patients presented with variable degrees of symptoms of LCI, such as fatigue, diminished sex drive and libido or ED. The results suggest that the patients sustained severe gonadal damage to both their germ cells (GC) as well as the LC compartment (P < 0.001). We characterised two distinct functional subsets of LC insufficiency: Type I: compensated type with high LH and normal T levels and low T/LH ratio: (n = 102); and type II: uncompensated type (premature andropause) with high LH and low testosterone levels with low T/LH ratio (n = 15). Although type II patients had more severe LC damage than type I, patients in both groups were symptomatic. We recommend that symptomatic patients in both groups may benefit from a therapeutic trial with testosterone replacement treatment (TRT) for 3–6 months. Bone Marrow Transplantation (2001) 28, 497–502.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, University College London Hospitals NHS Trust, London, UK

    R Chatterjee & HH McGarrigle

  2. Department of Haematology, University College London Hospitals NHS Trust, London, UK

    PD Kottaridis, N McKeag, S Mackinnon & AH Goldstone

  3. Department of Research and Development Directorate, University College London Hospitals NHS Trust, London, UK

    J Eliahoo

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  1. R Chatterjee
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Chatterjee, R., Kottaridis, P., McGarrigle, H. et al. Patterns of Leydig cell insufficiency in adult males following bone marrow transplantation for haematological malignancies. Bone Marrow Transplant 28, 497–502 (2001). https://doi.org/10.1038/sj.bmt.1703160

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