霍奇金病治疗前后睾丸功能障碍

S. Viviani , G. Ragni , A. Santoro , L. Perotti , E. Caccamo , E. Negretti , P. Valagussa , G. Bonadonna
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引用次数: 145

摘要

在7年的时间里,对92名男性霍奇金病患者在治疗前进行了精液分析。67%的患者精液显示生育机会降低(即少精症、弱精症和/或畸形精症)。卵泡刺激素(FSH)、黄体生成素、睾酮和催乳素的平均基础水平均在正常范围内。77例经MOPP/ABVD交替治疗后完全缓解的患者(甲氯胺酮、长春新碱、丙卡嗪、强的松;阿霉素,博来霉素,长春碱,达卡巴嗪),评估睾丸功能。87%的患者无精子,9%的患者精液异常,只有4%的患者正常精子。42名重新评估的患者中只有17名(40%)在27个月后恢复了精子发生,并且通常不受预处理精子质量的影响。化疗后FSH均值[20.45 (S.E. 1.7) mUI/ml]明显优于治疗前均值。治疗前后睾酮和催乳素的平均值没有差异。我们的研究结果表明,在何杰金氏病患者中,大约有一半在开始化疗前受到性腺功能减退的影响。通过交替使用MOPP/ABVD,半数患者记录了持续性睾丸功能障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Testicular dysfunction in Hodgkin's disease before and after treatment

Over a 7-year period, semen analysis was performed in 92 male patients with Hodgkin's disease prior to therapy. In 67% of patients semen revealed a decreased chance for fertility (i.e. oligozoospermia, asthenozoospermia and/or teratozoospermia). The mean basal levels of follicle-stimulating hormone (FSH), luteinising hormone, testosterone and prolactin were in the normal range. In 77 patients in complete remission after alternating MOPP/ABVD (mechlorethamine, vincristine, procarbazine, prednisone; doxorubicin, bleomycin, vinblastine, dacarbazine), testicular function was assessed. 87% of patients were azoospermic, 9% had semen abnormalities and only 4% were normospermic. Recovery of spermatogenesis was documented in only 17 of 42 (40%) reassessed patients after a median time of 27 months and was generally not affected by pretreatment sperm quality. After chemotherapy, the mean value of FSH [20.45 (S.E. 1.7) mUI/ml] was significantly superior compared with that of the mean pretreatment values. No difference was documented in the mean testosterone and prolactin values tested before and after treatment. Our findings indicate that, of patients with Hodgkin's disease, about half are affected by hypogonadism before starting chemotherapy. By utilising alternating MOPP/ABVD, persistent testicular dysfunction was documented in half of the patients.

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