GONADAL-FUNCTION FOLLOWING ABVD THERAPY FOR HODGKINS-DISEASE

To assess the effect of combination chemotherapy with doxorubicin, ble omycin, vinblastine, and dacarbazine (ABVD) on gonadal function in pat ients treated for Hodgkin's disease, we assessed 38 male patients with Hodgkin's disease who were >15 years of age and in complete remission for the development of secondary sexual characteristics, sexual habit s, and fatherhood after treatment. Semen analysis and serum hormone le vel estimation of follicle-stimulating hormone (FSH), leutinizing horm one (LH), and testosterone (T) were done in all cases. Twenty-six pati ents received ABVD therapy and 12 received a combination of ABVD with CORP or MOPP (cyclophosphamide or nitrogen mustard, vincristine, proca rbazine, and prednisone). Radiation of the pelvic region was done in o ne case. Median time between completion of therapy and assessment of g onadal function was 34 months (range, 12-68 months). Secondary sexual characteristics developed normally in all patients. Azoospermia was se en in one patient from the ABVD group and 10 patients from the COPP/AB VD group (p < 0.001). Serum FSH levels were significantly higher in th e COPP/ABVD group than in the ABVD group (23.5 versus 4.7 mIu/ml; p < 0.001) The levels were in the normal range in 23 patients from the ABV D group, as compared to four in the COPP/ABVD group (88.5% versus 33.3 %; p < 0.001). Three patients treated with ABVD fathered children post therapy. We conclude that ABVD is associated with relatively better pr eservation of gonadal function.