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Article
October 14, 1988

Gonadal Activity and Chemotherapy-Induced Gonadal Damage

Author Affiliations

University of Texas M. D. Anderson Cancer Center Houston
Memorial Sloan-Kettering Cancer Center New York

University of Texas M. D. Anderson Cancer Center Houston
Memorial Sloan-Kettering Cancer Center New York

JAMA. 1988;260(14):2065. doi:10.1001/jama.1988.03410140076024
Abstract

To the Editor.—  Drs Rivkees and Crawford1 have reviewed the relationship of pubertal status to chemotherapyinduced gonadal damage and have concluded that the quiescent gonad of prepuberty may confer a protective effect during chemotherapy. If one could suppress germ cell proliferation and induce a quiescent gonad in the adult, then potentially the gonad might be protected from this cytotoxic drug-induced damage. Although Drs Rivkees and Crawford cite only three studies2-4 and suggest that this hypothesis has been "surprisingly little-tested," there are now more than 20 studies in laboratory animals and humans testing this "germ cell suppression hypothesis."5 Hodgkin's disease has been the model in the human studies because of the high curability, its occurrence during the reproductive years, and the frequent sterility caused by the combination chemothera py used for this disease. After the first report of a possible protective effect of oral contraceptives,2 subsequent studies

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