ESPE2022 Rapid Free Communications Sex Development and Gonads (6 abstracts)
Sertoli cell dysfunction at diagnosis in children with haematological malignancies
Jimena Lopez Dacal 1 , Silvina Prada 2 , Maria Gabriela Ropelato 1 , Maria Gabriela Ballerini 1 , Maria Eugenia Rodriguez 1 , Marcela E. Gutierrez 2 , Marcela Soria 2 , Lorena Morán 2 , Cristina Ferraro 2 , Patricia Bedecarrás 1 , Guillermo Drelichman 2 , Luis Aversa 2 , Ignacio Bergadá 1 , Rodolfo A. Rey 1 & Romina P. Grinspon 1
1Centro de Investigaciones Endocrinológicas “Dr. César Bergadá” (CEDIE), CONICET – FEI – División de Endocrinología. Hospital de Niños Ricardo Gutiérrez., Buenos Aires, Argentina; 2División de Hematología, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
Aim: To determine Sertoli cell function at diagnosis and after 3 months of chemotherapy.
Methods: A prospective cohort study was performed including children with acute lymphoblastic leukaemia, acute myeloid leukaemia, or non-Hodgkin lymphoma. Serum levels of AMH were evaluated at diagnosis and after 3 months during chemotherapy. Results were analysed as standard deviation scores according to pubertal stage and expressed as median (range).
Results: 93 boys, aged 6.09 yr (0.04-17.53) were included in the study, 75.3% were prepubertal at diagnosis, 73.1% with acute lymphoblastic leukaemia, 7.5% with acute myeloid leukaemia and 19.4% with non-Hodgkin lymphoma. Median AMH was -0.50 SDS (-2.07 to +6.27 SD) at diagnosis. Mean AMH was significantly different from a theoretical value of 0 SDS (P value <0.0001). 9.7% of the children had serum AMH below the 3rd percentile and 41.9% below the 25th percentile. After 3 months of chemotherapy, AMH was -0.30 SD (-1.74 to +5.00 SD), significantly higher than AMH at diagnosis (Wilcoxon matched pairs signed rank test, two tailed P value 0.0002), and not significantly different from a theoretical value of 0 SDS (P value 0.23). 3.2% of the children had serum AMH below the 3rd percentile and 30.1% below the 25th percentile.
Conclusion: Children with haematological malignancies have lower AMH concentrations compared to the reference population, reflecting a Sertoli cell dysfunction, at diagnosis. After 3 months of chemotherapy, AMH concentration increased significantly. The causes of the decreased function of Sertoli cells at diagnosis have yet to be determined.
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