The relationship of gonadal activity and chemotherapy-induced gonadal damage

S. A. Rivkees and J. D. Crawford
Pediatric Endocrine Unit, Massachusetts General Hospital, Boston 02114.

We tested the hypothesis that chemotherapy-induced gonadal damage is proportional to the degree of gonadal activity during treatment. Thirty studies that evaluated gonadal function after cyclophosphamide therapy for renal disease or combination chemotherapy for Hodgkin's disease or acute lymphocytic leukemia provided data for analysis. Data were stratified according to sex, illness, chemotherapeutic regimen and dose, and pubertal stage at the time of treatment. Chemotherapy-induced damage was more likely to occur in patients who were treated when sexually mature compared with those who were treated when prepubertal. Males were significantly more frequently affected than females when treated for renal disease or Hodgkin's disease. Chemotherapy-induced damage was also more likely to occur when patients were treated with large doses of alkylating agents. These data suggest that chemotherapy-induced damage is proportional to gonadal activity. Further efforts are needed to test whether induced gonadal quiescence during chemotherapy will reduce the strikingly high incidence of gonadal failure following chemotherapy.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Cancer Treatment and the Ovary: The Effects of Chemotherapy and Radiation
COHEN
Ann. N. Y. Acad. Sci. 2008;1135:123-125.
ABSTRACT | FULL TEXT  

Ovarian Failure after Chemotherapy for Breast Cancer and the Role of Gonadotropin-releasing Hormone Analogs in Protection of Ovarian Function
Moore
Am Soc Clin Oncol Ed Book 2008;2008:39-42.
ABSTRACT | FULL TEXT  

Inhibin B is superior to FSH as a serum marker for spermatogenesis in men treated for Hodgkin's lymphoma with chemotherapy during childhood
van Beek et al.
Hum Reprod 2007;22:3215-3222.
ABSTRACT | FULL TEXT  

Fertility preservation in young women undergoing breast cancer therapy.
Sonmezer and Oktay
The Oncologist 2006;11:422-434.
ABSTRACT | FULL TEXT  

Prevention of chemotherapy-induced menopause by temporary ovarian suppression with goserelin in young, early breast cancer patients
Del Mastro et al.
Ann Oncol 2006;17:74-78.
ABSTRACT | FULL TEXT  

Spermatogenesis After Cancer Treatment: Damage and Recovery
Howell and Shalet
J Natl Cancer Inst Monogr 2005;2005:12-17.
ABSTRACT | FULL TEXT  

Fertility preservation in female patients
Sonmezer and Oktay
Hum Reprod Update 2004;10:251-266.
ABSTRACT | FULL TEXT  

Anovulation in the prevention of cytotoxic-induced follicular attrition and ovarian failure
Letterie
Hum Reprod 2004;19:831-837.
ABSTRACT | FULL TEXT  

Personal practice: Fertility preservation for children treated for cancer (1): scientific advances and research dilemmas
Grundy et al.
Arch. Dis. Child. 2001;84:355-359.
FULL TEXT  

Cyclophosphamide for the treatment of systemic lupus erythematosus
Takada et al.
Lupus 2001;10:154-161.
ABSTRACT  

Ovarian Rescue/Protection from Chemotherapeutic Agents
Blumenfeld
Reproductive Sciences 2001;8:S60-S64.
ABSTRACT  

Preservation of Fertility and Ovarian Function and Minimizing Chemotherapy-Induced Gonadotoxicity in Young Women
Blumenfeld et al.
Reproductive Sciences 1999;6:229-239.
ABSTRACT  

Long-term toxicity of immune suppression in juvenile rheumatic diseases
Laxer
Rheumatology (Oxford) 1999;38:743-746.
FULL TEXT  

Preserving ovarian function in patients receiving cyclophosphamide
Slater et al.
Lupus 1999;8:3-10.