Relationship between inhibin B, puberty, and secondary sex characteristics in childhood cancer survivors.

Abstract

e22018 Background: Prognosis in childhood cancer improved with intensive tx regimens, improved survival,concerns&issues related to QOL become crucial point of interest. Methods: Gonadal functions were studied in 33M,22F survivors of childhood cancers treated w gonadotoxic chemotherapy,with HL,NHL, ALL,Osteosarcoma,Rhabdomyosarcoma. All event-free survivors for > 1year, postpubertal, > 15 years of age at the time of study, 8 pts received abdominal RT,9 pts had prophylactic cranial RT. Patients answered a questionnaire concerning sexual functions,underwent a comprehensive physical examination, clinical evaluation of pubertal development, secondary sex characteristics,menstrual history, measurement of FSH, LH,sex steroids, inhibinB, compared w age-matched controls. Results: All patients had normal pubertal development for age,Females showed no significant differences in secondary sex characteristics, than controls &the progression of puberty, adult-type hair growth in males were significantly late (P:0.002) than controls, low levels of testosterone were found in all.Pubertal development normal in female patients, w elevated FSH than control.(P:0.025)FSH levels in males didn't differ,inhibinB levels were significantly lower than control.(P:0.022).We couldn't demonstrate significant association with age at dx,time elapsed after tx,dx type,gonadotoxic agent.. Conclusions: Our study showed tx of childhood cancer could lead to gonadal toxicity.Our study investigating relationship between puberty,secondary sex characteristics,inhibinB in early postpubertal stage. Findings suggest that, even in the presence of gonadal toxicity, in females, secondary sex characteristics&puberty weren't affected.Inhibin B as a marker for gonadal toxicity is not superior to FSH. In fact that, we found a decrease in InhibinB as the only marker of gonadal dysfunction in males.With normal pubertal development &FSH levels in postpubertal males,low detection of inhibinB can be used as an early,sensitive marker for gonadal toxicity.Late adult-type hair growth with low testosterone demonstrating chemotherapy-induced testicular damage. Clinical trial information: BAP-2734.