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The introduction of modern methods of combined therapy: chemotherapy and radiotherapy, allows the cure more than 90% of children and adolescents with Hodgkin's disease (HD). However, the intensive treatment carries the risk of early and late complications. One of the late effects is gonadal dysfunction which may develop in men as well as in women. In this report preliminary results of testicular function assessment in young men after HD therapy. Testicular function was evaluated in 24 young men (age: 10.6-18.2 years, median 14.6 years at the beginning of treatment, and 18.5-24.6 years, median 21.4 years at the end of therapy) treated between January 1, 1999 and December 31, 2009. in Department of Pediatric Oncology and Hematology PAIP JU-CM in Kraków, according to PGP-HD-97 protocol. Multidrug chemotherapy combined with low-dose involved-field radiotherapy (15-25 Gy) was used in treatment in 21 men, and 3 other men were treated with chemotherapy only. Therapy was completed in all analyzed patients. Physical examination and Tanner stages of pubic hair and genital development were recorded as well as the plasma levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone (TST) were measured in all patients. Testicular volumes were measured in 14 men. The study was conducted between January 1, 2009 and December 31, 2009. All men reached Tanner stages of pubic hair and genital development appropriate for their age. One hundred and fourteen measurements of hormones levels were performed in all of patients. At least one abnormal result of measurements was found in 16/24 (66.7%) of men. The most frequent abnormality was the increased level of FSH (in 15 patients, 60.5% of FSH measurements). Abnormal results of measurements were found in 14/20 (70%) patients who received 6 chemotherapy cycles and in 2/4 patients treated with 3-4 cycles. Within the group of patients with abnormal results eight men previously received subdiaphragmatic region radiotherapy. Semen analysis was performed in one man and revealed azoospermia. Initial results of reproductive system assessment indicate the impairment of testicular function depending on intensity of treatment. Further observation and repeated gonadal function tests (including semen analysis) are needed in young men with completed HD treatment. These studies are essential especially for young people who intend to have children.

Introduction: A complex anticancer treatment leads to different late effects e.g. gonadal damage in adulthood. The information about gonadal function (steroido- and spermatogenesis) after the treatment in prepubertal period are ambiguous., The Aim of Study: was to evaluate testicular function in young men (Tanner puberty stages IV and V) treated in prepubertal period for childhood malignancies., Material and Methods: In thirty-two pubertal and postpubertal male survivors of childhood cancer (acute lymphoblastic leukemia, ALL - 14, non-Hodgkin lymphoma, NHL - 6, Hodgkin lymphoma, HL and solid tumors - 4) testicular volume and serum FSH, LH, testosterone, inhibin B and calculated quotient inhibin B:FSH were measured. Controls were 15 healthy boys matched by age and Tanner stage., Results: In the whole studied group the mean values of FSH, LH and testosterone did not differ from control, while inhibin B was lower (87.5+/-96.3 vs. 196.5+/-66.8 ng/l; p<0,0003). The lowest values of inhibin B were found in HL (46,15+/-35,12 ng/l) and after ALL treatment (71,1+/-39,8 ng/l). We did not observe differences in hormonal parameters after NHL treatment. The inhibin B-to-FSH ratio was lower, especially after treatment for HL., Conclusions: Inhibin B is a sensitive marker of gonadal damage. Anticancer therapy in prepubertal period may lead to disturbances in spermatogenesis.

The effects of male mice to vinblastine (VBL) and combined X-rays-vinblastine treatments on the sperm quantity and quality, fertility and induction of foetal deaths and congenital malformations in the offspring were investigated. VBL and combined X-rays-VBL exposure caused decrease in testes weight and sperm count as well as increased percent of abnormal spermatozoa. Both vinblastine and X-rays-vinblastine combination induced increase in frequency of DNA single strand breaks in germ cells. The highest dose of VBL induced decrease of percent of pregnant females, decrease of live foetuses and induction of dominant lethal mutations after exposure some stages of spermatogenesis. Combined exposure to low doses of X-rays and vinblastine enhanced the frequency of dead implants. After exposure to VBL on its own as well as to combination of low doses of both agents increase in the frequency of congenital malformations was not observed.

An attempt to introduce combined therapy for patients with testicular seminoma in the II degree of clinical advancement was undertaken at the Centre of Oncology. Combined therapy consisted of 3 courses of PVB in the following daily doses: DDP 100 mg/m2 i.v. on the first day; VLB 10 mg i.v. on the first and second day; bleomycin 30 mg i.v. on the second, ninth and sixteenth day every 21 days, and 60Co on lymphatic glands area in which metastases were diagnosed prior to chemotherapy. Twenty three patients were treated that way between January 1985 and June 1989. Mean follow-up period after the treatment was 14 months. One patient died for the tumor, metastases to the lungs were diagnosed in one patient 9 months after completion of the treatment which ameliorated after "second" chemotherapy, and 22 patients (96%) are still free from the symptoms of active disease.