Clinical Study

BJC Open article

British Journal of Cancer (2009) 100, 455–463. doi:10.1038/sj.bjc.6604892 www.bjcancer.com
Published online 20 January 2009

Gonadal function in male patients after treatment for malignant lymphomas, with emphasis on chemotherapy

C E Kiserud1, A Fosså2, T Bjøro3, H Holte2, M Cvancarova1 and S D Fosså1,4

  1. 1Department of Clinical Cancer Research, National Resource Center for long term effects after Cancer, Norwegian Radium Hospital, Rikshospitalet University Hospital, Oslo 0310, Norway
  2. 2Department of Oncology, Cancer Clinic, Norwegian Radium Hospital, Rikshospitalet University Hospital, Oslo 0310, Norway
  3. 3Department of Medical Biochemistry, Rikshospitalet University Hospital and University of Oslo, Oslo, Norway
  4. 4Faculty Division the Norwegian Radium Hospital, University of Oslo, Oslo O316, Norway

Correspondence: Dr CE Kiserud, E-mail: cecilie.essholt.kiserud@radiumhospitalet.no

Received 10 July 2008; Revised 17 December 2008; Accepted 18 December 2008
Advance online publication 20 January 2009

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Abstract

Gonadal function was assessed in male lymphoma survivors based on serum hormone levels (LH, FSH, testosterone, SHBG), and was related to treatment, age and observation time. Male patients less than or equal to50 years at diagnosis treated for Hodgkin's (HL) and/or non-Hodgkin's lymphoma (NHL) at the Norwegian Radium Hospital from 1 January 1980 to 31 December 2002 were included. Five treatment groups were defined: 1: radiotherapy only and/or low gonadotoxic chemotherapy (both HL and NHL)(‘No/low’), 2: medium gonadotoxicity chemotherapy for NHL (‘med-NHL’), 3: medium gonadotoxicity chemotherapy for HL (‘med-HL’), 4: highly gonadotoxic chemotherapy for NHL (‘high-NHL’), 5: highly gonadotoxic chemotherapy for HL (‘high-HL’). Gonadal hormone levels were categorised into three groups: 1: All gonadal hormones within normal range (normal), 2: Isolated elevated FSH, with LH, SHBG and testosterone within normal range (exocrine hypogonadism), 3: Testosterone below and/or LH above normal range (endocrine hypogonadism). One hundred and forty-four (49%) of the patients had normal gonadal hormones, 60 (20%) displayed exocrine hypogonadism and almost one-third (n=90, 30%) had endocrine hypogonadism. Compared to those treated with no/low gonadotoxic chemotherapy patients from all other treatment groups had significantly elevated risk for exocrine hypogonadism. Patients from the other treatment groups, except those in the med-NHL group, also had significantly elevated risk for endocrine hypogonadism compared with the group treated with no/low gonadotoxic chemotherapy. Men aged above 50 years at survey were about five times more likely to have endocrine hypogonadism compared with those less than 40 years. Because of the adverse health effects following long-lasting endocrine hypogonadism, gonadal hormones should be assessed regularly in male lymphoma survivors, especially after treatment with alkylating agents and high-dose chemotherapy with autologous stem cell support and in male patients who are 50 years and older.

Keywords:

male lymphoma survivors; chemotherapy; gonadal function

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