Abstract: Objective To investigate the influence of different intensity of chemotherapy on hormonal markers of gonadal function in children with acute lymphoblastic leukemia (ALL). Methods Based on the chemotherapy regimens of South China children's leukemia Group (SCCLG-ALL- 2016 ), a total of 112 newly diagnosed ALL preadolescent were included. Serum anti-Müllerian hormone (AMH) and inhibin B (INHB) levels were detected by chemiluminescence assay before and 3 , 6 , 12 and 18 months after chemotherapy, and were compared according to gender and risk type. Results A total of 112 patients ( 58 boys and 54 girls) with ALL were enrolled, with a median age of 4 . 1 ( 2 . 5 - 6 . 1 ) years. There were 24 high-risk children, 58 medium-risk children, and 30 low-risk children. In the normal control group, there were 57 patients ( 28 boys and 29 girls), with a median age of 4 . 0 ( 2 . 5 - 6 . 3 ) years. Repeated measures analysis of variance showed that there were statistically significant differences in serum INHB levels among low-risk, medium-risk and high-risk boys (F= 3 . 60 , P= 0 . 036 ) at different times before and after chemotherapy (F= 81 . 67 , P< 0 . 001 ). Time of chemotherapy and risk type had an interaction effect on serum INHB level (F=5.12, P< 0 . 001 ). There was no statistically significant difference in serum AMH level between low-risk, medium-risk and high-risk girls (F= 0 . 62 , P= 0 . 551 ), and there was statistically significant difference in serum AMH level between different time before and after chemotherapy (F=21 . 32 , P< 0 . 001 ). Time of chemotherapy and risk type had an interaction effect on serum AMH level (F=2.33, P= 0 . 029 ). Conclusions Although the children with ALL were still prepubertal, SCCLG-ALL- 2016 chemotherapy could change the hormonal markers of gonadal function. Moreover, the influence degree of high-risk chemotherapy was higher than that of low and medium risk chemotherapy, suggesting that gonadal function of children with ALL was impaired to varying degrees during chemotherapy.

Key words: anti-Müllerian hormone; inhibin B; chemotherapy; gonadal function; acute lymphoblastic leukemi