Testicular dysfunction after cyclophosphamide-vincristine-procarbazine-prednisolone chemotherapy for advanced hodgkin's disease a long-term follow-up study
✍ Scribed by B. S. Charak; Rahul Gupta; Pranoti Mandrekar; Nandini A. Sheth; Shripad D. Banavali; T. K. Saikia; R. Gopal; K. A. Dinshaw; Chief S. H. Advani
- Publisher
- John Wiley and Sons
- Year
- 1990
- Tongue
- English
- Weight
- 370 KB
- Volume
- 65
- Category
- Article
- ISSN
- 0008-543X
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✦ Synopsis
Gonadal functions were evaluated in 92 male patients after treatment for advanced Hodgkin's disease. The patients received six to ten cycles of cyclophosphamide, vincristine, procarbazine, and prednisolone (COPP) chemotherapy. All patients were in remission and were followed for 1 to 17 years (median, 6). Testicular atrophy was noticed in 89 (96.7%) patients. All patients remained azoospermic during the period of follow-up. The testosterone levels did not differ before and after treatment. The follicle stimulating hormone levels rose from pretreatment values (mean k standard deviation) of 179.27 f 21.99 ng/ml to 578.79 k 102.36 ng/ ml after the treatment; the rise was significant (P < 0.001). The luteinizing hormone levels rose from pretreatment values of 106.96 k 20.37 ng/ml to 127.37 ? 32.19 ng/ ml after treatment; the rise was significant (P < 0.05). Testicular biopsy specimens in 19 patients showed germinal aplasia in all cases. It is concluded that six or more cycles of COPP chemotherapy for advanced Hodgkin's disease in men leads to permanent sterility. Cancer 65:1903-1906, 1990.
MONG long-term survivors after modern treatment
A for Hodgkin's disease (HD), late sequelae including secondary neoplasms and gonadal dysfunction are being increasingly re~ognized.'-~ Most of the drugs in the mustine, vincristine, procarbazine, prednisolone (MOPP) chemotherapy regimen for HD induce germinal aplasia, azoospermia, and infertility in man.4-6 An alternative combination, doxorubicin, bleomycin, vinblastine, and dacarbazine is as effective as the MOPP regimen and is less toxic to the gonads, but it is costlier and out of reach for most patients in developing c ~u n t r i e s . ~ Another chemotherapy protocol COPP (cyclophosphamide substituted for mustine) yields results comparable to MOPP