SLEEP‐RELATED GONADOTROPIN RHYTHMS IN CHILDREN FOLLOWING TREATMENT OF ACUTE LEUKEMIA: RECOVERY OF THE HYPOTHALAMO‐PITUITARY‐GONADAL AXIS AFTER CHEMOTHERAPY AND CNS‐IRRADIATION

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Abstract
Twelve children (5 girls and 7 boys, between the ages of 6 and 20 years) in complete remission from previous ALL who had completed their entire anti‐leukemic treatment program and who had been off all chemotherapy for at least one year, were included in a study of sleep‐related prolactin and gonadotropin rhythms. All the patients had received prophylactic CNS‐irradiation. The patients in early puberty showed a sleep‐dependent FSH rhythm. Patients in middle‐to‐late puberty had sleep‐related FSH and LH rhythms, and estradiol and testosterone plasma concentrations were normal for their pubertal stage, suggesting recovery of the hypothalamo‐pituitary‐gonadal feedback system. We conclude that the neuro‐endocrine axis is not permanently injured by CNS‐irradiation and anti‐leukemic therapy.