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- W2003249336 abstract "D ear S ir, the article “The hypothalamus–pituitary–gonad axis and testicular function in male patients after treatment for haematological malignancies” by Kauppila et al. [1] reminds us of the adverse effects of aggressive chemotherapy or chemoradiotherapy on gonadal function. As the authors note, patients treated during adulthood have the highest incidence of deleterious effects on the gonads. Likewise, the reversibility of hormonal changes caused by antineoplastic agents is related to the cumulative dose received, the duration of treatment, and the type of drug. Cyclophosphamide was administered to 14 out of 19 patients in their study, and it is one of the most commonly cytotoxic drugs associated with infertility [2]. They state that there are no protective agents to prevent gonadal damage. In this respect, we would like to mention a recent study on the use of testosterone to prevent cyclophosphamide-induced azoospermia [3]. In that study, 10 adult patients who had the nephrotic syndrome were treated with a monthly intravenous bolus of cyclophosphamide. The average duration of treatment was 8 months, and the total dose was 10.4 g. Five patients received cyclophosphamide alone, and the other five patients also received testosterone before starting cyclophosphamide therapy and during treatment. Four out of five who received cyclophosphamide alone were azoospermic for as long as 6 months after the end of therapy. In contrast, spermatogenesis returned to normal in the five patients treated with testosterone. Testosterone inhibits germinal cell activity, and cyclophosphamide appears to cause more damage on active germinal cells because of their elevated mitotic activity. It may explain why prepubertal patients seem to recover gonadal function better than adults do. Because cyclophosphamide is a widely used agent, the confirmation of these findings by other studies with a large number of patients and a long interval from therapy to the assessment would represent an important advance. Received 16 December 1998; accepted 2 February 1999" @default.
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- W2003249336 date "1999-07-01" @default.
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- W2003249336 title "The hypothalamus-pituitary-gonad axis and testicular function in male patients after treatment for haematological malignancies" @default.
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- W2003249336 doi "https://doi.org/10.1046/j.1365-2796.1999.00552.x" @default.
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