Reversal of Fludarabine Induced Testicular Damage in a Patient with Chronic Lymphocytic Leukaemia (CLL), by Suppression of Pituitary-Testicular Axis Using Gonadotrophin Releasing Hormone (GnRH)

Ratna Chatterjee Reproductive Medicine Unit, Department Of Obstetrics and Gynaecology

Panagiotis D. Kottaridis Department of Haematology, University College London Hospitals, Huntley street., London, WCIE, 6AU, UK

Hugh McGarrigle Reproductive Medicine Unit, Department Of Obstetrics and Gynaecology

Anthony H. Goldstone Department of Haematology, University College London Hospitals, Huntley street., London, WCIE, 6AU, UK

Abstract

We describe a case of a 47 year old man with CLL who was treated with 7 courses of fludarabine with simultaneous suppression of his pituitary-testicular axis (P-T) with Gonadotrophin releasing hormone (GnRH) and replacement treatment with testosterone. Despite initial gonadal damage as evident by endocrine and sperm studies, testicular recovery was observed 11 months post treatment. Although spontaneous recovery cannot be ruled out, continous treatment with GnRH and testosterone may play a crucial role protecting the gonads from the cytotoxic effects of the chemotherapeutic agents.

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Reversal of Fludarabine Induced Testicular Damage in a Patient with Chronic Lymphocytic Leukaemia (CLL), by Suppression of Pituitary-Testicular Axis Using Gonadotrophin Releasing Hormone (GnRH)

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Reversal of Fludarabine Induced Testicular Damage in a Patient with Chronic Lymphocytic Leukaemia (CLL), by Suppression of Pituitary-Testicular Axis Using Gonadotrophin Releasing Hormone (GnRH)

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