Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019829 (Hodgkin's disease)
 30,247 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Sperm examinations and/or measurements of plasma FSH, LH and testosterone were performed on 54 patients with Hodgkin's disease before and/or after 3 or 6 courses of multiagent chemotherapy (MOPP). In 24 patients without constitutional symptoms the results of fresh and frozen sperm examination were similar to those of a fertile control population. In 23 patients, pretreatment hormone levels were identical with those of controls. During the first year following completion of chemotherapy all patients had azoospermia and high FSH levels. From the second year onwards, 2 out of 16 patients had normal spermatogenesis (the wife of one of these gave birth to a healthy child), while 4 had grossly deficient spermatogenesis and 10 azoospermia. All male patients suffering from Hodgkin's disease should be asked to give sperm for freezing before chemotherapy and should be informed that spermatogenesis may be resumed from the second posttreatment year.
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PMID:[Male fertility in Hodgkin's disease before and after chemotherapy (author's transl)]. 726 3

The testicular function of 47 men who had been treated by MOPP chemotherapy for a Hodgkin's disease was studied in a long-term survey. Azoospermia was constant during at least 14 months after completion of the treatment. After a follow-up period of 89.4 +/- 54.7 months, 26 men were still azoospermic. No correlation could be found between the therapeutic regimen and the results of semen analysis. For the same treatment, some men recovered spermatogenesis within 5 years, others after more than 10 years while some were still azoospermic after 20 years. However, the association of infra-diaphragmatic irradiation to high dose MOPP therapy had a profound detrimental effect on spermatogenesis: only 3/13 men recovered. Sperm recovery was often incomplete: 17/21 men had a sperm count below 20 million ml-1. Yet, spontaneous pregnancies were obtained with severe oligozoospermia: only 1/11 sperm counts performed close to fertilization exceeded 20 million ml-1, and 8 were below 5 millions ml-1. FSH failed to be either a sensitive or a specific marker of sperm recovery, a discrepancy between FSH level and spermiogram being noticed in 18.2% of cases.
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PMID:Male reproductive potential after MOPP therapy for Hodgkin's disease: a long-term survey. 759 33

We treated 137 Turkish children with biopsy-proven Hodgkin's disease, followed up between the years 1964 and 1989. Most patients were treated and were in advanced stage with histological subtype of mixed cellularity (67.5%). Radiotherapy (Mantle form) and/or MOPP, ABVD and OPPA combination chemotherapy regimens were used in 75.84% of patients. The follow-up period in these patients ranged from 5 to 24 years. The late effects in 28 patients who were evaluated for the late sequelae of chemoradiotherapy are presented. Seven out of 28 patients showed retarded sexual maturation. Testicular and ovarian functions were assessed in 11 patients, all of whom showed elevated serum FSH levels and 2 azoospermia. Analysis of thyroid functions was carried out in patients receiving radiotherapy to the neck. The thyroid gland was palpable in 6 patients. Further analysis showed diffuse hyperplasia in 5 and nodular in 1 patient. The nodule was excised and reported as "nodular colloidal goiter". Two patients had elevated TSH levels. "Swan-like neck" was observed in 3 patients who had received 40 to 42 Gy radiotherapy to the neck. Cirrhosis due to chronic hepatitis B infection was diagnosed in 2 patients as an unusual late complication. The secondary malignancy occurred in only 1 case in the form of "fibrosarcoma". The second neoplasm was probably radiation-induced as it occurred in the field of prior radiotherapy.
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PMID:Late effects of chemoradiotherapy in pediatric Hodgkin's disease. 859 34

The major challenge for this generation of children's cancer specialists is to sustain the significant improvement in survival rates, while at the same time minimising treatment-induced late adverse effects. The available evidence suggests that, following first line treatment of acute lymphoblastic leukaemia (ALL), current treatment regimens used in the UK are unlikely to cause sterilisation in either gender. For men who are treated for Hodgkin's disease with 6 or more courses of antineoplastic therapy, azoospermia is the rule. Childhood studies have clearly indicated that the prepubertal testis is not protected from antineoplastic therapy that is potentially sterilising. The interpretation of tests of ovarian function in women treated for cancer in childhood is difficult, but there is increasing evidence of ovarian dysfunction in children treated for Hodgkin's disease. Reassuringly there is no evidence of an increased risk of miscarriage following antineoplastic therapy or an increased number of abnormalities in the offspring. The growth patterns and requirement for growth hormone replacement therapy in children treated for ALL are still unclear. There is good evidence that the intensity and duration of combination cytotoxic antineoplastic therapy received by children with ALL influences the pattern of growth, and that adjuvant antineoplastic therapy for children treated for a brain tumour is an important factor in final height achieved. A child who has been treated for cancer should not be discharged from follow-up. Late effects may have significant implications in later life, and an understanding of these effects is essential to enable balanced decisions to be made regarding the benefits and risks of currently available agents.
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PMID:Late effects of antineoplastic therapy in childhood on growth and endocrine function. 894 94

To assess the effect of combination chemotherapy with doxorubicin, bleomycin, viablastine, and decarbazine (ABVD) on gonadal function in patients treated for Hodgkin's disease, we assessed 38 male patients with Hodgkin's disease who were > 15 years of age and in complete remission for the development of secondary sexual characteristics, sexual habits, and fatherhood after treatment. Semen analysis and serum hormone level estimation of follicle-stimulating hormone (FSH), leutinising hormone (LH), and testosterone (T) were done in all cases. Twenty-six patients received ABVD therapy and 12 received a combination of ABVD with COPP or MOPP (cyclophosphamide or nitrogen mustard, vincristine, procarbazine, and prednisone). Radiation of the pelvic region was done in one case. Median time between completion of therapy and assessment of gonadal function was 34 months (range, 12-68 months). Secondary sexual characteristics developed normally in all patients. Azoospermia was seen in one patient from the ABVD group and 10 patients from the COPP/ABVD group (p < 0.001). Serum FSH levels were significantly higher in the COPP/ABVD group than in the ABVD group (23.5 versus 4.7 mlu/ml; p < 0.001) The levels were in the normal range in 23 patients from the ABVD group, as compared to four in the COPP/ABVD group (88.5% versus 33.3%; p < 0.001). Three patients treated with ABVD fathered children post-therapy. We conclude that ABVD is associated with relatively better preservation of gonadal function.
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PMID:Gonadal function following ABVD therapy for Hodgkin's disease. 925 88

With the increasing success of multimodality anticancer therapy, most men of reproductive age will survive their malignancy. Reproductive function is a principal concern of these men. Health-care providers are shifting the focus of oncologic care toward improving the quality of life in cancer patients, particularly with regard to fertility. For unknown reasons, fertility and sexual function are adversely affected in men with germ cell tumors and Hodgkin's disease prior to the initiation of therapy. Despite these pretreatment abnormalities, fertility potential remains good. Cancer therapy utilizing physical and chemical treatment methods can temporarily or permanently damage spermatogonia, resulting in azoospermia and infertility. Recovery of spermatogenesis can take up to 10 years after therapy. Alternative treatment regimens can preserve reproductive function while maintaining high therapeutic efficacy. Surgical treatment should be directed toward maintaining the neurovascular mechanisms responsible for seminal emission and ejaculation. With new developments in assisted reproductive techniques, even cancer patients with severe oligoasthenospermia can father children. These techniques have not been found to increase the incidence of major or minor birth defects.
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PMID:Cancer and male factor infertility. 957 28

The improved survival in recent years of young males suffering from cancer, and an understanding of the gonadotoxic effects of chemotherapy treatment, have motivated patients and clinicians to preserve fertility potential before embarking on adjuvant therapy. Among 231 men (mean age 28.0; range 15-56 years) diagnosed with malignant disease and referred to our unit for semen cryopreservation, 112 patients (49.8%) had reduced sperm quality of <10 x 10(6) motile spermatozoa per ejaculate; however, most had sufficient suitable spermatozoa for freezing. In 40 patients (17.3 %) the semen samples were not frozen because of complete azoospermia (n = 32) or only immotile sperm in the ejaculate (n = 2), while six men were unable to produce a single sample. Some 79 men had testicular tumours (group I), 121 suffered from haematological malignancy (leukaemia or lymphoma; group II), and 27 had cancer of different causes (group III). Men in group I had significantly lower (P < 0.001) sperm quality compared with groups II and III. There was no difference between patients with seminoma and non-seminoma tumours. In the haematological malignancy group there was no difference in sperm parameters between leukaemia (n = 12) and lymphoma (n = 77) patients, but patients with Hodgkin's lymphoma had significantly lower sperm quality compared with non-Hodgkin's lymphoma. Following chemotherapy, six couples attended the clinic for assisted conception treatment using the frozen semen. Two had successful intrauterine insemination cycles which each resulted in delivery of a healthy girl; one couple had conceived in their first in-vitro fertilization (IVF) attempt, followed by delivery of healthy twins. Two women conceived after intracytoplasmic sperm injection treatment and the sixth woman achieved only biochemical pregnancy after numerous IVF and frozen embryo replacement cycles. We recommend that a properly designed programme for semen cryopreservation for cancer patients should be developed in leading tertiary assisted conception centres, which have adequate facilities and experience for cryopreservation and can offer the whole range of appropriate assisted reproductive treatment and counselling.
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PMID:A programme of semen cryopreservation for patients with malignant disease in a tertiary infertility centre: lessons from 8 years' experience. 985 91

In recent years, continuous optimization of therapy has decisively improved the prognosis of Hodgkin's disease. However, this improvement in overall survival has also led to an increase in several possible late effects which the clinician must be aware of. Due to the appearance of chronic fatigue symptoms, cardiopulmonary problems, hypothyreosis and damage to the gonadal system including azoospermia and ovarian insufficiency, the mostly young patients often suffer a persistent reduction in quality of life. In addition, the increased incidence of second malignancies following successful primary treatment presents a considerable problem. While complete remission and prolonged survival were previously the main objectives in the therapy of malignant lymphomas, reduction or avoidance of toxicity is now becoming more and more central. This development has led to the increasing importance of late sequelae and quality of life as endpoints in modern therapy trials in oncology.
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PMID:[Long-term toxic sequelae of the treatment of Hodgkin's disease]. 1094 98

We tested for azoospermia factor (AZF) deletions 17 loci corresponding to AZF subintervals a-d in 17 cases of testicular tumors occurring in Finns. While DNA samples from 48 CEPH and 32 Finnish males showed no deletions, patients with testicular cancer displayed AZF deletion mosaicisms in various non-tumor tissues (13 cases) and specific deletion haplotypes in tumor tissues (10 cases). Two of the cases with AZF deletions were testicular non-Hodgkin lymphomas indicating that Y-microdeletions appear also in malignancies other than seminoma and non-seminoma tumors. In good agreement with this assumption, we detected one AZF deletion in normal cells from 1 of 5 HNPCC cases, heterozygous for an MLH1 mutation. We propose that AZF deletions occur in early embryogenesis due to mutations of TSPY, mismatch repair (MMR), or X-specific genes. Since fathers of testicular, tumor cases did not exhibit AZF deletions, we assumed they were not carriers of the mutation inducing AZF deletion-mosaicisms. Therefore, tumor cases should have received the MMR gene or X mutations via the maternal lineage, or for the case of TSPY and MMR genes via a sperm carrying a mutation occurred in the paternal germ-cell line. We consider AZF microdeletions in non-tumor cells to be part of a broader pattern of chromosome instability producing susceptibility to testicular tumors. Clonal transformation and expansion of one of these tumor-susceptible cell lineages give rise to testicular tumors showing genome anomalies characteristic of testicular cancers (i12p, LOH and genetic imbalance for various autosomal regions, Y- and autosomal MSI, specific AZF deletion haplotypes).
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PMID:Mosaic AZF deletions and susceptibility to testicular tumors. 1205 3

The male reproductive system is especially sensitive to the deleterious effects of many natural environmental agents, the workplace, and medical agents. Immunosuppressants and anticancer agents, which improve the prognosis of survival or the quality of life of patients, induce temporary sterility in all treated patients and complete sterility in 50% of treated patients. These agents affect spermatogenesis. Quantitative effects include oligo- and azoospermia. Qualitative effects involve spermatozoa changes, which inhibit implantation and their ability to fertilize the ovum and adversely affect embryonic development. Research is and has been underway to identify possible ways to preserve spermatogenesis. The Centers for the Study and Conservation of Human Sperm (CECOS) in France receives sperm every year from many men with cancer, especially Hodgkin's disease or testicular cancer, who wish CECOS to preserve their sperm through cryopreservation before they undergo chemotherapy or radiotherapy. Using less deleterious agents instead of cytotoxic drugs is a possible means to protect spermatogenesis. Agents which have been tested include antioxidants, gonadotropin-releasing hormone analogs, follicle stimulating hormone, and steroids. Of these agents, medroxyprogesterone acetate and testosterone together (MPA + T) have been examined the most in rats (contraception and protection) and in men (contraception). The rat studies show that MPA + T can indeed protect spermatogenesis. Clinical trials in men are needed to support these findings. INSERM supports a multidisciplinary group examining spermatogenesis preservation called Prosperm, which will likely be the impetus for the start-up of such clinical trials. Prosperm members include researchers and physicians who network to keep each other up-to-date on spermatogenesis protection. Their collaboration is especially needed, since recent epidemiological studies indicate that diverse environment factors adversely affect spermatogenesis.
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PMID:[Spermatogenesis protection: myth or reality?]. 1228 96


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