Alteraciones en la función gonadal en varones pospuberales supervivientes de leucemia linfoblástica aguda y enfermedad de Hodgkin
Alterations in gonadal function in post-pubertal male survivors of acute lymphoblastic leukemia and hodgkin's disease
L. Soriano Guillén, M.T. Muñoz Calvo*, J. Pozo Román, T. Contra Gómez, M. Buño Soto, J. Argente Oliver
Secciones de Endocrinología y Oncología Pediátricas. Hospital Universitario Niño Jesús. Universidad Autónoma. Madrid
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García-Consuegra Molina, R. Merino Muñoz" "autores" => array:2 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "García-Consuegra Molina" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Merino Muñoz" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403300774698?idApp=UINPBA00005H" "url" => "/16954033/0000005300000004/v1_201307051520/S1695403300774698/v1_201307051520/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Alteraciones en la función gonadal en varones pospuberales supervivientes de leucemia linfoblástica aguda y enfermedad de Hodgkin" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "318" "paginaFinal" => "323" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "L. Soriano Guillén, M.T. Muñoz Calvo, J. Pozo Román, T. Contra Gómez, M. Buño Soto, J. Argente Oliver" "autores" => array:6 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Soriano Guillén" ] 1 => array:3 [ "nombre" => "M.T." "apellidos" => "Muñoz Calvo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Pozo Román" ] 3 => array:2 [ "nombre" => "T." "apellidos" => "Contra Gómez" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Buño Soto" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Argente Oliver" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Secciones de Endocrinología y Oncología Pediátricas. Hospital Universitario Niño Jesús. Universidad Autónoma. Madrid" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Sección de Endocrinología Pediátrica. Hospital Universitario Niño Jesús. Avda. Menéndez y Pelayo, 65. 28009 Madrid." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Alterations in gonadal function in post-pubertal male survivors of acute lymphoblastic leukemia and hodgkin's disease" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2000-05-31" "fechaAceptado" => "2000-06-30" "PalabrasClave" => array:1 [ "es" => array:2 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec186461" "palabras" => array:4 [ 0 => "Gonadal function" 1 => "Chemotherapy" 2 => "Hodgkin's disease" 3 => "Acute lymphoblastic leukemia" ] ] 1 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186462" "palabras" => array:4 [ 0 => "Función gonadal" 1 => "Quimioterapia" 2 => "Enfermedad de Hodgkin" 3 => "Leucemia linfoblástica aguda" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Estudiar la función gonadal en varones supervivientes de leucemia linfoblástica aguda (LLA) y enfermedad de Hodgkin (EH).</p> <span class="elsevierStyleSectionTitle">Pacientes y método</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se estudiaron 13 varones pospuberales (estadio V de Tanner), 9 con LLA y 4 con EH, que habían recibido poliquimioterapia durante el período prepuberal. El grupo control lo constituyeron 13 varones voluntarios de edad similar y de desarrollo puberal completo. Se determinó: tamaño testicular, espermiograma, valores séricos de hormonas foliculoestimulante (FSH) y luteinizante (LH), basales y tras estímulo con GnRH (hormona liberadora de gonadotropinas), y testosterona basal (T1). Se consideró que existía daño del epitelio germinal cuando se encontró, al menos, uno de los siguientes criterios: a) oligospermia/azoospermia; b) aumento de FSH basal o tras GnRH, o c) reducción del volumen testicular. Se consideró que existía lesión de las células de Leydig cuando los valores plasmásticos de testosterona basal se encontraron disminuidos, o los valores de LH, basales o tras estímulo, aumentados.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Los pacientes diagnosticados de EH presentaron una clara alteración de la función germinal y, en menor medida, de la función de las células de Leydig, con diferencias significativas respecto al grupo control (p < 0,001) en: pico de FSH (19,7 ± 18 frente a 4,8 ± 1,8 mU/ml), pico de LH (49,2 ± 31 frente a 33,4 ± 10,0 mU/ml), testosterona (4,1 ± 0,6 ng/ml frente a 5,9 ± 0,3 ng/ml) y volumen testicular (16,6 ± 2,8 frente a 22,5 ± 2,4 ml). De los 4 pacientes con EH, tres presentaron azoospermia y uno oligoespermia. Los pacientes supervivientes de LLA no presentaron diferencias significativas en ninguno de los parámetros bioquímicos y clínicos con el grupo control, si bien, de los 9 pacientes estudiados, dos presentaron oligospermia.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los protocolos quimioterápicos empleados en el tratamiento de la EH y la LLA producen una elevada incidencia de daño germinal y de alteración subclínica de las células de Leydig en los varones con EH; mientras que en los pacientes diagnosticados de LLA se encuentra sólo una afectación leve de la línea germinal. El estado prepuberal no protege los testículos del efecto nocivo de la quimioterapia.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To study gonadal function in male patients surviving acute lymphoblastic leukemia (ALL) or Hodgkin's disease (HD).</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Thirteen postpubertal males were studied (Tanner stage V), 9 with ALL and 4 with HD, who had received poly chemotherapy during the pre-puberal period. The control group was composed of 13 male volunteers of similar ages and with complete pubertal development. Testicular size, spermiogram, serum levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) before and after stimulus with gonadotropin-releasing hormone (GnRH), and serum testosterone levels were determined. The germinal epithelium was believed to be damaged when at least one of the following criteria was present: 1) oligospermia/azoospermia, 2) increase in serum FSH levels before or after GnRH, or 3) reduction in testicular volume. Lesions in Leydig's cells were thought to exist when serum testosterone levels were reduced or when serum LH levels, before or after stimulus, increased.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Patients with HD presented clear alterations in germinal function and, to a lesser degree, in the function of Leydig's cells. Significant differences compared with the control group (p < 0.001) were found in peak FSH (19.7 ± 18 vs 4.8 ± 1.8 ???/mL), peak LH (49.2 ± 31 vs 33.4 ± 10.0 pUI/mL), serum testosterone (4.1 ± 0.6 vs 5.9 ± 0.3 ng/mL) and testicular volume (16.6 ± 2.8 vs 22.5 ± 2.4 mL). Of the four patients with HD, three presented azoospermia and one oligospermia. No significant differences in any of the clinical or biochemical parameters studied were found in patients surviving ALL compared with the control group, but two of the nine patients studied presented oligospermia.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The chemotherapy protocols used in the treatment of HD and ALL produced a high incidence of germinal cell damage and subclinical alterations in the Leydig's cell function in males with HD. In patients with ALL, the germinal line was only mildly affected. Prepubertal state does not protect the testes from the harmful effects of chemotherapy.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:28 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 7 | 13 | 20 |
| 2024 Octubre | 77 | 50 | 127 |
| 2024 Septiembre | 60 | 40 | 100 |
| 2024 Agosto | 62 | 65 | 127 |
| 2024 Julio | 79 | 57 | 136 |
| 2024 Junio | 44 | 68 | 112 |
| 2024 Mayo | 64 | 46 | 110 |
| 2024 Abril | 36 | 29 | 65 |
| 2024 Marzo | 53 | 40 | 93 |
| 2024 Febrero | 55 | 47 | 102 |
| 2024 Enero | 67 | 30 | 97 |
| 2023 Diciembre | 69 | 19 | 88 |
| 2023 Noviembre | 80 | 25 | 105 |
| 2023 Octubre | 74 | 25 | 99 |
| 2023 Septiembre | 36 | 30 | 66 |
| 2023 Agosto | 45 | 23 | 68 |
| 2023 Julio | 32 | 29 | 61 |
| 2023 Junio | 46 | 33 | 79 |
| 2023 Mayo | 36 | 22 | 58 |
| 2023 Abril | 19 | 17 | 36 |
| 2023 Marzo | 25 | 31 | 56 |
| 2023 Febrero | 16 | 23 | 39 |
| 2023 Enero | 18 | 37 | 55 |
| 2022 Diciembre | 27 | 34 | 61 |
| 2022 Noviembre | 50 | 50 | 100 |
| 2022 Octubre | 35 | 56 | 91 |
| 2022 Septiembre | 20 | 31 | 51 |
| 2022 Agosto | 34 | 56 | 90 |
| 2022 Julio | 27 | 52 | 79 |
| 2022 Junio | 30 | 43 | 73 |
| 2022 Mayo | 22 | 37 | 59 |
| 2022 Abril | 35 | 54 | 89 |
| 2022 Marzo | 27 | 52 | 79 |
| 2022 Febrero | 18 | 40 | 58 |
| 2022 Enero | 23 | 50 | 73 |
| 2021 Diciembre | 20 | 39 | 59 |
| 2021 Noviembre | 29 | 46 | 75 |
| 2021 Octubre | 36 | 59 | 95 |
| 2021 Septiembre | 28 | 34 | 62 |
| 2021 Agosto | 21 | 32 | 53 |
| 2021 Julio | 27 | 30 | 57 |
| 2021 Junio | 33 | 47 | 80 |
| 2021 Mayo | 24 | 51 | 75 |
| 2021 Abril | 17 | 99 | 116 |
| 2021 Marzo | 76 | 22 | 98 |
| 2021 Febrero | 68 | 19 | 87 |
| 2021 Enero | 38 | 26 | 64 |
| 2020 Diciembre | 50 | 22 | 72 |
| 2020 Noviembre | 30 | 18 | 48 |
| 2020 Octubre | 24 | 11 | 35 |
| 2020 Septiembre | 23 | 6 | 29 |
| 2020 Agosto | 39 | 11 | 50 |
| 2020 Julio | 32 | 14 | 46 |
| 2020 Junio | 41 | 11 | 52 |
| 2020 Mayo | 30 | 11 | 41 |
| 2020 Abril | 20 | 8 | 28 |
| 2020 Marzo | 49 | 9 | 58 |
| 2020 Febrero | 30 | 14 | 44 |
| 2020 Enero | 44 | 19 | 63 |
| 2019 Diciembre | 45 | 23 | 68 |
| 2019 Noviembre | 30 | 9 | 39 |
| 2019 Octubre | 29 | 10 | 39 |
| 2019 Septiembre | 21 | 30 | 51 |
| 2019 Agosto | 24 | 27 | 51 |
| 2019 Julio | 27 | 32 | 59 |
| 2019 Junio | 29 | 46 | 75 |
| 2019 Mayo | 28 | 58 | 86 |
| 2019 Abril | 37 | 19 | 56 |
| 2019 Marzo | 21 | 17 | 38 |
| 2019 Febrero | 33 | 21 | 54 |
| 2019 Enero | 23 | 24 | 47 |
| 2018 Diciembre | 15 | 10 | 25 |
| 2018 Noviembre | 34 | 19 | 53 |
| 2018 Octubre | 41 | 11 | 52 |
| 2018 Septiembre | 18 | 1 | 19 |
| 2018 Julio | 1 | 0 | 1 |
| 2018 Junio | 1 | 0 | 1 |
| 2018 Mayo | 2 | 0 | 2 |
| 2018 Abril | 6 | 0 | 6 |
| 2018 Marzo | 10 | 0 | 10 |
| 2018 Febrero | 9 | 0 | 9 |
| 2018 Enero | 10 | 0 | 10 |
| 2017 Diciembre | 6 | 0 | 6 |
| 2017 Noviembre | 10 | 0 | 10 |
| 2017 Octubre | 8 | 0 | 8 |
| 2017 Septiembre | 10 | 0 | 10 |
| 2017 Agosto | 9 | 0 | 9 |
| 2017 Julio | 11 | 0 | 11 |
| 2017 Junio | 16 | 9 | 25 |
| 2017 Mayo | 21 | 8 | 29 |
| 2017 Abril | 15 | 13 | 28 |
| 2017 Marzo | 18 | 3 | 21 |
| 2017 Febrero | 10 | 2 | 12 |
| 2017 Enero | 9 | 1 | 10 |
| 2016 Diciembre | 19 | 5 | 24 |
| 2016 Noviembre | 35 | 6 | 41 |
| 2016 Octubre | 17 | 9 | 26 |
| 2016 Septiembre | 16 | 5 | 21 |
| 2016 Agosto | 15 | 5 | 20 |
| 2016 Julio | 6 | 4 | 10 |
| 2016 Febrero | 2 | 0 | 2 |
| 2015 Diciembre | 4 | 0 | 4 |
| 2015 Octubre | 1 | 0 | 1 |
| 2015 Agosto | 0 | 14 | 14 |
| 2015 Julio | 5 | 0 | 5 |
| 2015 Junio | 7 | 8 | 15 |
| 2015 Mayo | 13 | 10 | 23 |
| 2015 Abril | 12 | 0 | 12 |
| 2015 Marzo | 10 | 0 | 10 |
| 2015 Febrero | 10 | 7 | 17 |
| 2015 Enero | 22 | 1 | 23 |
| 2014 Diciembre | 10 | 2 | 12 |
| 2014 Noviembre | 12 | 0 | 12 |
| 2014 Octubre | 8 | 0 | 8 |
| 2014 Septiembre | 12 | 6 | 18 |
| 2014 Agosto | 12 | 2 | 14 |
| 2014 Julio | 12 | 1 | 13 |
| 2014 Junio | 20 | 2 | 22 |
| 2014 Mayo | 32 | 3 | 35 |
| 2014 Abril | 24 | 2 | 26 |
| 2014 Marzo | 17 | 8 | 25 |
| 2014 Febrero | 13 | 6 | 19 |
| 2014 Enero | 17 | 6 | 23 |
| 2013 Diciembre | 23 | 2 | 25 |
| 2013 Noviembre | 10 | 9 | 19 |
| 2013 Octubre | 19 | 10 | 29 |
| 2013 Septiembre | 23 | 9 | 32 |
| 2013 Agosto | 14 | 11 | 25 |
| 2013 Julio | 7 | 2 | 9 |
| 2013 Junio | 4 | 4 | 8 |
| 2013 Mayo | 6 | 6 | 12 |
| 2013 Abril | 2 | 3 | 5 |
| 2013 Marzo | 7 | 6 | 13 |
| 2013 Febrero | 23 | 3 | 26 |
| 2013 Enero | 7 | 1 | 8 |
| 2012 Diciembre | 8 | 1 | 9 |
| 2012 Noviembre | 7 | 2 | 9 |
| 2012 Octubre | 3 | 1 | 4 |
| 2012 Septiembre | 3 | 1 | 4 |
| 2012 Agosto | 0 | 1 | 1 |
| 2000 Septiembre | 1522 | 0 | 1522 |
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