Leydig-cell function in children after direct testicular irradiation for acute lymphoblastic leukemia

N Engl J Med. 1983 Jul 7;309(1):25-8. doi: 10.1056/NEJM198307073090106.


To assess the effect of testicular irradiation on testicular endocrine function, we studied 12 boys with acute lymphoblastic leukemia who had been treated with direct testicular irradiation 10 months to 8 1/2 years earlier. Insufficient Leydig-cell function, manifested by a low response of plasma testosterone to chorionic gonadotropin or an increased basal level of plasma luteinizing hormone (or both), was observed in 10 patients, 7 of whom were pubertal. Two of these patients had a compensated testicular endocrine insufficiency with only high plasma concentrations of luteinizing hormone. Testosterone secretion was severely impaired in three pubertal boys studied more than four years after testicular irradiation. A diminished testicular volume indicating tubular atrophy was found in all pubertal patients, including three who had not received cyclophosphamide or cytarabine. These data indicate that testosterone insufficiency is a frequent complication of testicular irradiation, although some patients continue to have Leydig-cell activity for several years after therapy.

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Child, Preschool
  • Chorionic Gonadotropin
  • Follicle Stimulating Hormone / blood
  • Follow-Up Studies
  • Gonadotropin-Releasing Hormone
  • Humans
  • Leukemia, Lymphoid / drug therapy
  • Leukemia, Lymphoid / radiotherapy*
  • Leydig Cells / physiology*
  • Luteinizing Hormone / blood
  • Male
  • Puberty
  • Testis / radiation effects*
  • Testosterone / blood
  • Testosterone / metabolism*
  • Time Factors


  • Chorionic Gonadotropin
  • Gonadotropin-Releasing Hormone
  • Testosterone
  • Luteinizing Hormone
  • Follicle Stimulating Hormone