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Hum. Reprod. Advance Access originally published online on November 2, 2007
Human Reproduction 2007 22(12):3215-3222; doi:10.1093/humrep/dem313
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Inhibin B is superior to FSH as a serum marker for spermatogenesis in men treated for Hodgkin’s lymphoma with chemotherapy during childhood

Robert D. van Beek1,2, Marij Smit3, Marry M. van den Heuvel-Eibrink1, Frank H. de Jong4, Friederike G. Hakvoort-Cammel1, Cor van den Bos5, Henk van den Berg5, Rob F.A. Weber3, Rob Pieters1 and Sabine M.P.F. de Muinck Keizer-Schrama2,6

1 Department of Pediatric Oncology/Hematology, Erasmus MC—Sophia Children’s Hospital, Room Sp3435, PO Box 2060, 3000 CB Rotterdam, The Netherlands 2 Department of Pediatric Endocrinology, Erasmus MC—Sophia Children’s Hospital, Room Sp3435, PO Box 2060, 3000 CB Rotterdam, The Netherlands 3 Department of Andrology, Erasmus MC, Rotterdam, The Netherlands 4 Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands 5 Department of Pediatric Oncology, Emma Children’s Hospital, Academic Medical Center, Amsterdam, The Netherlands

6 Correspondence address. Tel: +31-10-4636786; Fax: +31-10-4636811; E-mail: s.demuinckkeizer-schrama{at}erasmusmc.nl

BACKGROUND: The aim of this study was to evaluate the long-term gonadal sequelae after treatment for childhood Hodgkin’s lymphoma with combination chemotherapy, using up to date fertility parameters and andrological evaluation, including for the first time inhibin B.

METHODS: There were 56 male patients treated from 1974–1998 for childhood Hodgkin’s lymphoma with combination chemotherapy ABVD or EBVD (adriamycin/epirubicin, bleomycin, vinblastine, dacarbazine) with or without MOPP (mechlorethamine, vincristin, prednisone, procarbazine) with the intention to avoid radiotherapy. These men were studied 15.5 years (range 5.6–30.2 years) after cessation of therapy. Serum follicle stimulating hormone (FSH), luteinizing hormone (LH), inhibin B, testosterone, sex hormone-binding globulin (SHBG), sperm concentration and sperm DNA integrity were determined.

RESULTS: In men treated with MOPP, median FSH and LH were significantly increased (P < 0.001) and inhibin B (17.5 versus 143 ng/l; P < 0.001) and sperm concentration (1.05 versus 49.5 x 106/ml; P < 0.05) were significantly decreased compared with patients treated without MOPP. The number of MOPP courses was significantly correlated with FSH and inhibin B levels. Only inhibin B showed an independent correlation with sperm concentration (r = 0.86; P < 0.001).

CONCLUSIONS: The use of MOPP chemotherapy causes permanent gonadal damage in the far majority of male survivors of childhood Hodgkin’s lymphoma and inhibin B is the most valuable serum marker for gonadal function.

Key words: inhibin B/fertility/Hodgkin’s lymphoma/long-term follow-up

Submitted on June 4, 2007; resubmitted on August 20, 2007; accepted on August 29, 2007.


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