Abstract
The hypothalamo-pituitary-gonadal axis was investigated in 4 pubertal boys (P 4-5) and in 2 prepubertal girls with acute lymphocytic leukemia (ALL). LH, FSH, PRL, the response to LHRH/TRH as well as testosterone (T), estradiol (E2) and sex-hormone-binding globulin (SHBG) were measured in each patient before therapy, on day 10 and 21 during, and 7 and 30 days after induction therapy. T, E2 and SHBG decreased in all patients together with a reduction in testicular volumes in pubertal boys (from 20-25 ml to 12-15 ml).Transient hypergonadotropic hypogonadism occured (mean LH from 9 mIU/ml to 18 mIU/ml, mean FSH from 7 mIU/ml to 15 mIU/ml) within 21 days of treatment. Simultaneously, mean prolactin levels increased from 8 ng/ml to 17 ng/ml together with an increased response to TRH stimulation. We conclude that during induction therapy in children with ALL a transient hypergonadotropic hypogonadism occured induced by a decreased steroid synthesis at the gonadal level and/or by a decreased SHBG synthesis.
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