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Horm Metab Res 1990; 22(9): 494-498
DOI: 10.1055/s-2007-1004954
Clinical

© Georg Thieme Verlag, Stuttgart · New York

Reproductive Toxicity with and without LHRHA Administration During Adjuvant Chemotherapy in Patients with Germ Cell Tumors

E. D. Kreuser1 , W. D. Hetzel2 , R. Hautmann3 , E. F. Pfeiffer2
  • 1Medizinische Klinik und Poliklinik, Abteilung Innere Medizin III (Hämatologie/Onkologie), Universität Ulm, Ulm, Germany
  • 2Medizinische Klinik und Poliklinik, Abteilung Innere Medizin I (Endokrinologie), Universität Ulm, Ulm, Germany
  • 3Medizinische Klinik und Poliklinik, Urologische Klinik, Universität Ulm, Ulm, Germany
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Publikationsverlauf

1989

1989

Publikationsdatum:
14. März 2008 (online)

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Summary

In order to evaluate the protective efficacy of an agonist of luteinizing hormone releasing hormone (LHRHA) on spermatogenic stem cells, we undertook a prospective study in patients with germ cell tumors. Following orchiectomy and unilateral lymph node dissection all patients received adjuvant chemotherapy consisting of 2 courses of PVB regimen (cisplatin, vinblastine and bleomycin). Six men were treated with LHRHA (d-Ser-(TBU)6 LHRH ethylamide) before, during and after PVB chemotherapy. Eight patients without LHRHA protection served as controls, receiving the identical chemotherapy. Follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone were within normal limits before therapy in all patients. In 6/6 protected patients, serum levels of FSH, LH and testosterone were effectively suppressed during pre-chemotherapeutic LHRHA administration. All protected patients showed elevated serum FSH levels and azoospermia after cessation of chemotherapy and LHRHA treatment due to germ and stem cell loss. Median FSH level and sperm density of the protected group normalized within 24 months after chemotherapy. In all unprotected patients elevated FSH values and azoospermia also occurred after chemotherapy. Likewise, median FSH level and sperm density normalized spontaneously in this group within 24 months after chemotherapy. Our results suggest completely reversible reproductive toxicity two years after 2 courses of adjuvant chemotherapy in all patients. Administration of LHRHA during chemotherapy seems to have no protective effects on germ cells since both groups developed reproductive toxicity. Furthermore, recovery time was identical in the protected and unprotected patients. FSH and LH could be used as diagnostic markers to assess the degree and duration of reproductive and endocrine gonadal toxicity after chemotherapy.

Key words

Gonadal Toxicity - Chemotherapy - LHRHA-Protection