Patterns of Leydig cell insufficiency in adult males following bone marrow transplantation for haematological malignancies
Patterns of Leydig cell insufficiency in adult males following bone marrow transplantation for haematological malignancies
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DOI：
10.1038/sj.bmt.1703160
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发表时间：
2001-09-01
影响因子：
4.8
通讯作者：
Goldstone, AH
中科院分区：
文献类型：
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作者：
Chatterjee, R;Kottaridis, PD;Goldstone, AH
性腺和性功能是骨髓移植（BMT）后生活质量的关键，但尚未有关于成人间质细胞（LQ）功能的大型研究发表。LC功能不全（LCI）可导致男性过早绝经，其后果包括性欲下降和勃起功能障碍（ED）引起的性发病率。此外，LCI可导致全身疲劳甚至骨质减少。我们回顾了117例因各种血液学恶性肿瘤接受骨髓移植的患者的移植前（移植前）和移植后3-18个月的性腺功能。患者表现出不同程度的LCI症状，如疲劳、性冲动和性欲减退或ED。结果表明，患者的生殖细胞（GC）和LC室均存在严重的性腺损伤（P < 0.001）。我们描述了两种不同的功能亚型：I型：高LH和正常T水平和低T/LH比值的代偿型（n = 102）；II型：无代偿型（男性早停），高LH和低睾酮水平，低T/LH比（n = 15）。尽管II型患者LC损伤比I型患者更严重，但两组患者均有症状。我们建议两组有症状的患者均可接受3-6个月的睾酮替代治疗（TRT）。
Gonadal and sexual function are key to quality of life following bone marrow transplantation (BMT), but no large studies have been published on Leydig cell (LQ function in adults. LC insufficiency (LCI) can cause premature andropause with its consequences including sexual morbidity from diminished libido and erectile dysfunction (ED). In addition, LCI can result in generalised fatigue and even osteopenia. We reviewed gonadal function pre-transplant (immediately prior to BMT) and at 3-18 months post BMT in 117 patients who underwent BMT for a variety of haematological malignancies. The patients presented with variable degrees of symptoms of LCI, such as fatigue, diminished sex drive and libido or ED. The results suggest that the patients sustained severe gonadal damage to both their germ cells (GC) as well as the LC compartment (P < 0.001). We characterised two distinct functional subsets of LC insufficiency: Type I: compensated type with high LH and normal T levels and low T/LH ratio: (n = 102); and type II: uncompensated type (premature andropause) with high LH and low testosterone levels with low T/LH ratio (n = 15). Although type II patients had more severe LC damage than type I, patients in both groups were symptomatic. We recommend that symptomatic patients in both groups may benefit from a therapeutic trial with testosterone replacement treatment (TRT) for 3-6 months.