Male Gonadal Function after Allogeneic Hematopoietic Stem Cell Transplantation in Childhood: A Cross-Sectional, Population-Based Study

Mathiesen, Sidsel; Sørensen, Kaspar; Nielsen, Malene Mejdahl; Suominen, Anu; Ifversen, Marianne; Grell, Kathrine; Lähteenmäki, Päivi; Frederiksen, Hanne; Juul, Anders; Müller, Klaus; Jahnukainen, Kirsi

doi:10.1016/j.bbmt.2020.05.009

Cited by 32 publications

(29 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a recent cross-sectional, long-term follow-up study, we reported a high risk of testosterone deficiency and azoospermia in adult survivors of pediatric allogeneic HSCT ( 8 ). In the present study, we aimed at combining these data with a retrospective analysis of reproductive hormones and semen samples in order to (i) characterize the development of testicular failure from the time of transplant, during puberty, and into adulthood, (ii) evaluate pubertal timing compared to the general population, and (iii) investigate the associations between post-transplant reproductive hormone levels during the pubertal years and testosterone deficiency and azoospermia in adulthood.…”

Section: Introductionmentioning

confidence: 98%

Childhood reproductive hormone levels after pediatric hematopoietic stem cell transplantation in relation to adult testicular function

Mathiesen

Sørensen

Ifversen

et al. 2021

Endocrine Connections

Self Cite

View full text Add to dashboard Cite

Objectives: Longitudinal assessment of testicular function after pediatric hematopoietic stem cell transplantation (HSCT) is needed to guide clinical follow-up. We investigated dynamics in male reproductive hormones after pediatric HSCT, focusing on pubertal timing and associations with testosterone deficiency and azoospermia in adulthood. Methods: This retrospective, longitudinal study included 39 survivors median 19 years after pediatric HSCT. Serum concentrations of LH, testosterone, FSH, and inhibin B from time of HSCT, during puberty, and into adulthood were analyzed. Pubertal timing (rise in LH and testosterone) was compared to a reference cohort of 112 healthy boys. Associations between reproductive hormone levels during puberty and adult testicular function (including semen quality) were investigated. Results: Pubertal induction with testosterone was needed in 6/26 patients who were prepubertal at HSCT. In the remaining patients, pubertal timing was comparable to the reference cohort. However, 9/33 patients (without pubertal induction) developed testosterone deficiency in early adulthood, which was associated with higher LH levels from age 14–16 years. Azoospermia in adulthood was found in 18/26 patients without testosterone substitution. Higher FSH and lower inhibin B levels from mid-pubertal age were associated with azoospermia in adulthood, in patients being prepubertal at HSCT. Conclusion: Our results indicate a substantial risk of deterioration in testicular function after pediatric HSCT, despite normal pubertal timing. Although reproductive hormone levels from mid-puberty indicated adult testicular function, prolonged follow-up into adulthood is needed in these patients, including clinical examination, reproductive hormone analysis, and semen sample for patients interested in their fertility potential.

show abstract

Section: Introductionmentioning

confidence: 98%

Childhood reproductive hormone levels after pediatric hematopoietic stem cell transplantation in relation to adult testicular function

Mathiesen

Sørensen

Ifversen

et al. 2021

Endocrine Connections

Self Cite

View full text Add to dashboard Cite

show abstract

“…Altogether, 59 (60%) of the participants had a malignant diagnosis. There were no statistically significant differences in the numbers of malignancies, age at HSCT, follow-up time or other transplant characteristics between participants and non-participants [23] (data not shown). The examination consisted of an updated medical anamnesis, questionnaires, laboratory measurements and a physical examination.…”

Section: Methodsmentioning

confidence: 90%

“…Previous phimosis or urethral stenosis that emerged after transplantation, but was later surgically removed, was considered a diagnostic sign of cGvHD with genital symptom score 1. The methods have been described in more detail in Mathiesen et al [23].…”

Section: Risk Factorsmentioning

confidence: 99%

Male Sexual Function after Allogeneic Hematopoietic Stem Cell Transplantation in Childhood: A Multicenter Study

Haavisto

Mathiesen

Suominen

et al. 2020

Cancers

Self Cite

View full text Add to dashboard Cite

There are many known endocrine complications after allogeneic hematopoietic stem cell transplantation (HSCT) in childhood including increased risk of biochemical hypogonadism. However, little is known about sexuality in adulthood following childhood HSCT. In this multicenter study, sexual functions and possible risk factors were assessed comprehensively in two national cohorts (Finland and Denmark) of male adult survivors of childhood HSCT. Compared to a healthy control group (n = 56), HSCT survivors (n = 97) reported less sexual fantasies, poorer orgasms, lower sexual activity with a partner and reduced satisfaction with their sex life, even in the presence of normal erectile functions and a similar frequency of autoerotic acts. Of the HSCT survivors, 35% were cohabitating/married and 66% were sexually active. Risk factors for poorer self-reported sexual functions were partner status (not cohabitating with a partner), depressive symptoms, CNS and testicular irradiation. Sexual dysfunction increased by age in the HSCT group with a pace comparable to that of the control group. However, because of the lower baseline level of sexual functions in the HSCT group, they will reach the level of clinically significant dysfunction at a younger age. Hence, male survivors of childhood HSCT should be interviewed in detail about their sexual health beyond erectile functions.

show abstract

“…Among patients exposed to CED <9,500 mg/m 2 , 83% demonstrated such recovery, with a peak at 5-7 years after the end of treatment [36]. Spermatogenic recovery has been reported 10-30 years following myeloablative HSCT but depends on the cumulative testicular irradiation dose as no recovery was observed in patients exposed to >12 Gy of irradiation dose [5].…”

Section: Male Patientsmentioning

confidence: 99%

“…Today, fertility-saving options As reported in the literature, impairment of fertility occurs in up to 30% of children treated with chemo-and/ or radiotherapy. This proportion rises considerably for patients who undergo hematopoietic stem cell transplantation (HSCT), which includes a combination of highdose alkylating agents with/without irradiation [2][3][4][5][6]. The risk of infertility has been established for the major gonadotoxic agents used in the treatment of pediatric cancer and should be carefully evaluated for proper fertility preservation counseling.…”

Section: Introductionmentioning

confidence: 99%

Fertility Preservation for Prepubertal Patients at Risk of Infertility: Present Status and Future Perspectives

et al. 2020

Self Cite

View full text Add to dashboard Cite

The increasing cure rate of cancer has led to a vast population of survivors having to face the late adverse effects of oncological treatments, with fertility impairment being one of the most sensitive issues for patients. Different options to preserve the fertility of adult patients are routinely used in clinical practice. However, fertility preservation strategies for prepubertal patients at risk of infertility are limited to the cryopreservation of immature gonadal tissue. In recent decades, many research efforts have been focused on the future use of cryopreserved gonadal tissue. This review discusses the common status of fertility preservation measures for pediatric patients undergoing gonadotoxic treatment, focusing especially on the challenges that remain to be solved in order to implement this fundamental service.

show abstract

Male Gonadal Function after Allogeneic Hematopoietic Stem Cell Transplantation in Childhood: A Cross-Sectional, Population-Based Study

Cited by 32 publications

References 35 publications

Childhood reproductive hormone levels after pediatric hematopoietic stem cell transplantation in relation to adult testicular function

Childhood reproductive hormone levels after pediatric hematopoietic stem cell transplantation in relation to adult testicular function

Male Sexual Function after Allogeneic Hematopoietic Stem Cell Transplantation in Childhood: A Multicenter Study

Fertility Preservation for Prepubertal Patients at Risk of Infertility: Present Status and Future Perspectives

Contact Info

Product

Resources

About