Skip to main content
. 2023 Feb 13;29(4):486–517. doi: 10.1093/humupd/dmad002

Table IV.

Serum FSH and inhibin B in childhood or adolescent males diagnosed with Hodgkin lymphoma.

Study N patients Age at diagnosis (years) Age at time of study (years) Follow-up (years) Treatment Outcome
Pre-treatment
Krawczuk-Rybak et al., 2012 10 15–18 NA NA NA

  • Significantly higher mean FSH value in HL patients when compared to healthy controls (6.3 ± 3.6 mIU/ml vs 4.6 ± 2.2 mIU/ml, P = 0.05).

    Significantly lower mean inhibin B concentration in HL patients when compared to healthy controls (100.4 ± 67.5 ng/l vs 153.6 ± 71.4 ng/l, P = 0.03).
Post-treatment
Aubier et al., 1989 10 10 (8–15) n.s. 9 (1–20)

  • Chemo: MOPP, VELBE, ABVD

  • No pelvic RT

 n = 4/4 (100%) with elevated FSH (i.e. >5 mcl/ml)
Ben Arush et al., 2000 12 13.7 (2.1–16.4) 22 (14.8–29.3) 9.8 (4.0–19.0)

  • Chemo: MOPP, ABVD

  • Pelvic RT: n = 4/201 (20%) 1650–4000 rad1

 n = 8/12 (67%) with elevated FSH (i.e. >14 mU/ml)
Bordallo et al., 2004 21 10 (6–19) 18 (17–23) (3–11)

  • Chemo: C-MOPP, ABV

  • No pelvic RT

  • n = 15/21 (71%) with elevated FSH (i.e. >2 SD of control)

  • n = 4/21 (19%) with low inhibin B (i.e. <100 pg/ml)

  • Median IB/FSH ratio was lower in HL survivors when compared to controls (31 (3.8–267.9) in HL survivors versus 142.1 (47.6–767.3) in healthy controls, P = 0.0002, respectively)
Brämswig et al., 1990 75 12.4 ± 2.1 17.2 ± 2.2 4.3 ± 1.9

  • Chemo: OPPA, COPP

  • Pelvic RT: n = 10/75 (13%), 18–40 Gy

 n = 26/65 (40%) with elevated FSH (i.e. >2 SD of controls)
Brignardello et al., 2016 40 <18 n.s. 14.01

  • Chemo: n.s.

  • Pelvic RT: n.s.

 n = 20/40 (50%) with elevated FSH (i.e. >10 IU/l) and low Inhibin B (<100 pg/ml)
Dhabhar et al., 1993 26 12 (4–15) 17 (15–23) 6.1 (2.3–11)

  • Chemo: COPP, ABVD, MOPP

  • No pelvic RT

 n = 14/23 (61%) with elevated FSH (i.e. >500 ng/ml)
Felicetti et al., 2020 55 <18 24.6 (21.8–29.4) n.s.

  • Chemo: n.s.

  • Pelvic RT: n = 32/1961 (16%)

 n = 25/55 (45%) with elevated FSH (i.e. >10 IU/l) and low Inhibin B (i.e. <100 pg/ml)
Gerres et al., 1998 46 14.9 ± 1.5 n.s. 11.7 ± 1.2

  • Chemo: OEPA, COPP

  • No pelvic RT

 n = 7/45 (16%) with elevated FSH (i.e. >2 SD of controls)
Gözdasoglu et al., 1995 10 n.s. 18 (11–29) (5–24)

  • Chemo: C-MOPP

  • Pelvic RT: n.s.

 n = 4/10 (40%) with elevated FSH (i.e. >2 SD of controls)
Green et al., 1981 17 12.1 (5.4–16.8) 16.3 (8.3–24.4) 3.4 (0.5–8.2)

  • Chemo: MOPP, CVPP, ABVD, BOPP

  • Pelvic RT: n = 9/17 (53%), 105–1090 rads

 n = 11/17 (65%) with elevated FSH (i.e. >16 mU/ml)
Hassel et al., 1991 25 13.6 ± 1.2 16.2 ± 1.2 2.4 (0.5–3.8)

  • Chemo: OPA, COMP

  • Pelvic RT: n.s.

 n = 0/25 (0%) with elevated FSH (i.e. >10 IU/l)
Heikens et al., 1996 19 11.0 (5–15) 19 (16–27) 14 (13–20)

  • Chemo: MOPP

  • Pelvic RT: n = 2/19 (11%), 20–25 Gy

 n = 15/19 (79%) with elevated FSH (i.e. >10 IU/l)
Hobbie et al., 2005 11 13.2 (6–19) 21 (18–31) 6.5 (1.5–21)

  • Chemo: COPP-ABV

  • No pelvic RT

 n = 5/11 (45%) with elevated FSH (i.e. >8 mIU/ml)
Mackie et al., 1996 46 12.2 (8.2–15.3) n.s. 6 (2.5–11.1)*

  • Chemo: ChlVPP

  • No Pelvic RT

 n = 41/46 (89%) with elevated FSH (i.e. >10 IU/l)
Müller et al., 1996 13 14 (3–17) 21 (19–34) 8 (1–18)

  • Chemo: CPP

  • Pelvic RT: n = n.s., 2–50 cGy

 n = 4/6 (66%) with elevated FSH (i.e. >10 IU/l)
Ortin et al., 1990 20 13 (12–15) n.s. 9 (up to 26)

  • Chemo: MOPP, PAVe, ABVD, VBM

  • Pelvic RT: n = 12/20 (60%), 20–44 Gy

 n = 7/10 (70%) with elevated FSH (i.e. >18 mIU/ml)
Papadakis et al., 1999 36 13.0 (2.4–22.6) 22.3 (15.1–32.5) 6.8 (2.0–19.3)*

  • Chemo: MDP

  • Pelvic RT: n = 6/36 (17%), dose n.s.

  • n = 18/36 (50%) with elevated FSH (cutoff n.s.)

  • Serial sampling: 3 patients with normal FSH levels remained normal over time, in 3 patients with elevated FSH concentrations, values remained abnormal over a period ranging from 1.1 to 8.2 years post-treatment.
Perrone et al., 1989 7 9.0 (2.4–12.0) 10.8 (3.0–18.0) 1.2 (0.2–6.5)

  • Chemo: ABVD, MOPP

  • Pelvic RT: n = 2/7 (29%), 2500 rad

 n = 2/7 (29%) with elevated FSH (i.e. >2 SD of controls)
Rafsanjani et al., 2007 33 9 (5–15) 19 (17–29) 7 (2–20)*

  • Chemo: MOPP, ABVD

  • No pelvic RT

 n = 6/33 (18%) with elevated FSH (>15 mIU/ml)
Schellong, 1998 31 13 >15 >4

  • Chemo: OPPA, OEPA, COPP

  • Pelvic RT: n.s.

 n = 0/31 (0%) with elevated FSH (cutoff n.s.), in patients who received only 2 cycles OEPA
Servitzoglou et al., 2015 50 10.8 (2.1–17.3) 21.1 (17.0–30.4) 9.3 (2.0–22.4)*

  • Chemo: MOPP, ABVD, ABVP, OPPA, COPP

  • Pelvic RT: n = 24/1711 (14%)

  • n = 20/45 (44%) with elevated FSH (i.e. >10 IU/l)

  • Of the patients with elevated FSH, 2 patients had a significant decrease in FSH serum concentrations over time. In one of the patients, FSH levels decreased from 11.0 to 4.6 IU/l, 6.3–10 years post-treatment. In the other patient, FSH levels decreased from 16.0 to 5.8 IU/l, 5.4–9 years post-treatment.
Shafford et al., 1993 40 n.s. >16 >6*

  • Chemo: ChlVPP, MOPP, MVPP, COPP, ABVD, PAVE, CCNU

  • Pelvic RT: n = 10/40 (25%), 2250–3500 cGy

  • n = 26/28 (93%) with elevated FSH (>8 u1−1) of patients who had chemotherapy. Of these, three pre-pubertal bots initially had normal FSH levels, which subsequently became elevated post-puberty

  • FSH levels remained elevated up to 17 years from end of therapy.
Sherins et al., 1978 15 (3–16) n.s. >2

  • Chemo: MOPP

  • Pelvic RT: n.s.

 n = 8/15 (53%) with elevated FSH (i.e. >10 IU/l)

  • n = 8/9 (89%) in pubertal boys with gynecomastia

  • n = 0/6 (0%) in pre-pubertal boys
van Beek et al., 2007a 56 11.4 (3.7–15.9) 27.0 (17.7–42.6) 15.5 (5.6–30.2)

  • Chemo: ABVD, EBVD, MOPP

  • No pelvic RT

  • Median FSH values were significantly higher in patients treated with MOPP when compared to patients that did not receive MOPP (MOPP+ 16.8 U/l (range 1.3–51, 40 patients) versus MOPP− 3.0 U/l (range 1.7–6.0, 16 patients), P = 0.01).

  • Median inhibin B levels were significantly lower in patients treated with MOPP when compared to patients that did not receive MOPP (MOPP+ 16.5 ng/l (range 0.0–173.0, 26 patients) versus MOPP− 144.0 ng/l (range 93.0–274.0, 12 patients), P = 0.01)
van den Berg et al., 2004 33 11.8 (3.8–17.2) n.s. 11.3 (0.5–24)

  • Chemo: MOPP, ABVD

  • Pelvic RT: n.s.

 n = 14/33 (42%) with elevated FSH (i.e. >10 IU/l).

  • n = 11/13 (85%) MOPP group.

  • n = 0/10 (0%) ABVD group.

  • n = 3/10 (30%) ABVD-MOPP group
Whitehead et al., 1982 15 11.2 (4.8–14.8) n.s. 3.3 (0,7–8)*

  • Chemo: MOPP, MVPP, ABVD

  • Pelvic RT: n = 5/17 (29%), 100–300 cGy dose received by testes

 n = 10/18* (56%) with elevated FSH (cutoff n.s., in text, within figures depicting basal and peak FSH concentrations, normal range of values are shown, the following cutoff values appears to be used: prepuberal and early puberty ±4 mU/ml, late pubertal ±7 mU.ml).

  • n = 0/4 (0%) pre-pubertal,

  • n = 2/4 (50%) early puberty,

  • n = 8/10 (80%) late pubertal/adult

  • One out of 4 subjects with multiple measurements had initially a raised FSH concentration and a normal FSH level on subsequent testing.

  • *Some subjects had multiple measurements. There were no separate results available per participant.
Zaletel et al., 2010 40 13 (3–16) 21 (13–34) 10 (4–27)

  • Chemo: MOPP, LOPP, ABV(D), COPP(A), OPPA

  • Pelvic RT: n = 11/40 (28%), 30 (22–45) Gy

  • n = 24/40 (60%) with elevated FSH (within paper referred to as ‘germinal epithelium damage’, cutoff n.s.)

  • n = 20/40 (50%) with primary hypogonadism (i.e. increased basal serum FSH/LH)
*

Follow-up period defined as years off treatment.

1

Reported number only available within total cohort (i.e. not specified for HL diagnosis or age-subgroup).

ABV, Adriamycin (Doxorubicin), Bleomycin, Vinblastine; ABVD, Adriamycin (Doxorubicin), Bleomycin, Vinblastine, Dacarbazine; ABVP, Adriamycin (Doxorubicin), Bleomycin, Vinblastine, Prednisone; BOPP, 1,3-bis(2-chloroethyI)-l-nitrosourea, Vincristine (Oncovin), Procarbazine, Prednisone; CCNU, Chlorambucil, Etoposide; Chemo, chemotherapy; CHlVPP, Chlorambucil, Vinblastine, Procarbazine, Prednisone; C-MOPP, Cyclophosphamide, Nitrogen mustard, Vincristine (Oncovin), Procarbazine, Prednisone; COMP, CCNU (Chlorambucil, Etoposide), Vincristine (Oncovin), Amethopterine, Procarbazine; COPP, Cyclophosphamide, Vincristine (Oncovin), Procarbazine, Prednisone; CPP, Cetuximab, Paclitaxel, Cisplatin; CVPP, Cyclophosphamide, Vinblastine, Procarbazine, Prednisone; EBVD, Epirubicin, Bleomycin, Vinblastine, Dacarbazine; Gy, gray; LOPP, Chlorambucil, Vincristine (Oncovin), Procarbazine, Prednisone; MDP, Adriamycin (Doxorubicin), Procarbazine, Prednisone, Vincristine (Oncovin), Cyclophosphamide; MOPP, Mechlorethamine, Vincristine (Oncovin), Procarbazine, Prednisone; MVPP, Mechlorethamine, Vinblastine, Procarbazine, Prednisone; NA, not applicable; n.s., not specified; N, number; OEPA, Vincristine (Oncovin), Etoposide, Prednisone, Adriamycin (Doxorubicin); OPA, Vincristine (Oncovin) Prednisone, Adriamycin (Doxorubicin); OPPA, Vincristine (Oncovin), Prednisone, Procarbazine, Adriamycin (Doxorubicin); PAVE, Prednisolone, Adriamycin (Doxorubicin), Vinblastine, Etoposide; PAVe, Procarbazine, Alkeran, Velban; RT, radiotherapy; VBM, Velban, Bleomycin, Methotrexate; VELBE, Vinblastine.

Age at diagnosis and time of study reported in median years (range) or mean ± SD.

The number of patients that received pelvic radiotherapy as (part of their) cancer treatment is reported. If mentioned, (pelvic) radiation dosage is included.