Testosterone deficiency in men surviving childhood acute leukemia after treatment with hematopoietic stem cell transplantation or testicular radiation: an L.E.A. study

• Published in: Bone marrow transplantation (Basingstoke) Vol. 56; no. 6; pp. 1422 - 1425
• Main Authors: Lopez, Romain, Plat, Geneviève, Bertrand, Yves, Ducassou, Stéphane, Saultier, Paul, Berbis, Julie, Pochon, Cécile, Hamidou, Zeinab, Poiree, Marilyne, Tabone, Marie-Dominique, Kanold, Justyna, Dalle, Jean-Hugues, Gandemer, Virginie, Paillard, Catherine, Sirvent, Nicolas, Plantaz, Dominique, Thouvenin, Sandrine, Pellier, Isabelle, Ansoborlo, Sophie, Leverger, Guy, Baruchel, André, Auquier, Pascal, Michel, Gérard
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.06.2021; Nature Publishing Group
• Subjects: 631/532/1542; 631/67/1990/283; 692/308/174; Acute leukemia; Bone marrow; Busulfan; Care and treatment; Cell Biology; Childhood; Children; Complications and side effects; Endocrine gland diseases; Endocrinology and metabolism; Health aspects; Hematology; Hematopoietic stem cells; Human health and pathology; Internal Medicine; Irradiation; Leukemia; Leukemia in children; Life Sciences; Luteinizing hormone; Medicine; Medicine & Public Health; Metabolic disorders; Metabolic syndrome; Patient outcomes; Public Health; Radiation; Radiotherapy; Reproductive Biology; Risk factors; Sexual reproduction; Stem cell transplantation; Stem Cells; Testes; Testosterone; Transplantation; France
• ISSN: 0268-3369; 1476-5365; 1476-5365
• DOI: 10.1038/s41409-020-01180-y

We included 255 patients from the L.E.A. French long-term follow-up cohort. All had received hematopoietic stem cell transplantation (HSCT) and/or testicular radiation for childhood acute leukemia and were older than 18 years at last L.E.A. evaluation. Total testosterone deficiency was defined as a <12 nmol/l level or by substitutive therapy, partial deficiency as normal testosterone with elevated luteinizing hormone (>10 UI/l). After myeloablative total body irradiation ( n = 178), 55.6% had total deficiency, 15.7% partial deficiency, and 28.7% were normal. A 4–6 Gy testicular boost and a younger age at HSCT increased significantly the risk. After a Busulfan-containing myeloablative conditioning regimen ( n = 53), 28.3% had total deficiency, 15.1% partial deficiency, 56.6% were normal (62.5% vs. 0% in patients without or with additional testicular radiation). A 24-Gy testicular radiation without HSCT induced total or partial deficiency in 71.4% and 28.6%, respectively ( n = 21). Total testosterone deficiency increased the risk of metabolic syndrome: 25% vs. 12.1% in men with partial testosterone deficiency and 8.8% when Leydig cell function was normal ( p = 0.031).