ESPE2024 Rapid Free Communications Sex Endocrinology and Gonads (6 abstracts)
Testicular function in prepubertal boys with haematological malignancies during and post chemotherapy: a prospective, longitudinal study
Jimena C. Lopez Dacal 1 , Silvina Prada 2 , Luciana Brenzoni 1 , María Arozarena 2 , María Gabriela Ropelato 1 , María Gabriela Ballerini 1 , María Eugenia Rodriguez 1 , Marcela Soria 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
Introduction: Haematological malignancies represent the most frequent cancer in children. While there is an extensive literature on testicular function in adult survivors of childhood cancer, focused on sperm and androgen production, scarce information exists on the immediate impact in prepubertal boys.
Aim: To characterise testicular function, focused on Sertoli cell biomarkers, from diagnosis up to 3 years after the end of chemotherapy in boys with haematological malignancies.
Methods: A prospective, longitudinal study was performed including prepubertal boys with acute lymphoblastic leukaemia, acute myeloid leukaemia, or non-Hodgkin lymphoma. Clinical examination and serum hormone levels (FSH, AMH, LH and testosterone) were assessed at diagnosis, every 3 months during chemotherapy and every 6 months up to 3 years after the end of treatment.
Results: 49 prepubertal boys, aged 4.4 years (0.7-10.1) were included. As previously reported, serum AMH was -0.39 SDS (-1.87 to +6.27) at diagnosis and increased to +0.03 (-1.16 to +3.10) after 3 months of chemotherapy (Wilcoxon matched pairs signed rank test, P = 0.0006). Subsequently, serum AMH SDS was -0.09 (-1.34 to +6.85) at 9-12 months of chemotherapy, +0.69 (-1.12 to +3.98) at 24 months, +0.93 (-1.15 to +7.39) 1 year after the end of treatment, +0.83 (-1.16 to +5.12) at 2 years, and +0.91 (-1.16 to +8.36) at 3 years. Serum AMH <3rd centile was observed in 8.2% of the patients at diagnosis, and in none during or after chemotherapy. 13 out of 49 patients entered puberty during the follow-up. Unexpectedly, in 7 (53.8%) AMH values >97th centile were observed. Serum FSH SDS was -0.70 (-2.2 to +2.43) at diagnosis, +0.05 (-1.78 to +3.49) after 3 months of chemotherapy, -0.15 (-1.39 to +8.95) at 9-12 months, -0.22 (-2.20 to +4.65) at 24 months, -0.29 (-2.1 to +3.22) 1 year after the end of treatment, -0.29 (-2.02 to +2.6) at 2 years, and -0.26 (-1.90 to +5.63) at 3 years. Serum FSH >97th centile was observed in 4-7% of the cases at the different visits during treatment and in <3% of the cases 1-3 years after the end of chemotherapy. Serum LH and testosterone were uninformative in prepubertal boys.
Conclusion: In prepubertal boys with haematological malignancies, testicular function was impaired at diagnosis but recovered in the vast majority after 3 months of chemotherapy and remained within the normal limits up to 3 years after the end of treatment. A delayed AMH decrease was observed in a subset of patients entering puberty.
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