Adult Testicular Volume Predicts Spermatogenetic Recovery After Allogeneic HSCT in Childhood and Adolescence

作者:Wilhelmsson Mari*; Vatanen Anu; Borgstrom Birgit; Gustafsson Britt; Taskinen Mervi; Saarinen Pihkala Ulla M; Winiarski Jacek; Jahnukainen Kirsi
来源:Pediatric Blood and Cancer, 2014, 61(6): 1094-1100.
DOI:10.1002/pbc.24970

摘要

BackgroundTesticular dysfunction and infertility are of major concern in long-term survivors after allogeneic hematopoietic stem cell transplantation (HSCT). This study assesses predictive factors for very long-term testicular recovery after allogeneic HSCT in childhood and adolescence. ProcedureTesticular volume, sperm production and long-term need of testosterone substitution were evaluated among 106 male survivors transplanted at Huddinge and Helsinki University Hospitals from 1978 through 2000, at a mean age of 84.6 years (range 1-17). A meanSD of 13 +/- 4.8 years (range 4-28) had elapsed since their HSCT and the mean age of the participants was 22 +/- 6.0 years (range 12-42). An adult testicular volume was recorded in 74 patients at a mean age of 19 +/- 3.3 years (range 14-36). ResultsRecipients conditioned with busulfan-based regimens or regimens containing only cyclophosphamide had significantly larger adult testicular volumes (mean volume 18ml and 16ml vs. 9ml, P<0.00001, respectively) and lower serum levels of FSH (mean 9IU and 5IU vs. 19IU, P<0.01 and 0.001, respectively) compared to those conditioned with total body irradiation (TBI). Multivariate analysis demonstrated that a non-leukemia diagnosis (P<0.01) and adult testicular volume 15ml (P<0.03) positively impacted spermatogenetic recovery. ConclusionsA larger adult testicular volume, normal serum levels of FSH and spermatozoa detected in a majority of seminal fluids after busulfan-based or cyclophosphamide conditionings suggest very long-term recovery of spermatogenesis after chemotherapy-based regimens. A simple measurement of adult testicular volume may help predict spermatogenetic potential among pediatric HSCT survivors. Pediatr Blood Cancer 2014;61:1094-1100.

  • 出版日期2014-6