Testicular dysfunction after cyclophosphamide‐vincristine‐procarbazine‐prednisolone chemotherapy for advanced hodgkin's disease a long‐term follow‐up study

Charak, Bishan S.; Mandrekar, Pranoti; Sheth, Nandini A.; Banavali, Shripad; Saikia, Tapan; Gopal, R; Dinshaw, Ketayun A.; Advani, Suresh H.

doi:10.1002/1097-0142(19900501)65:9<1903::aid-cncr2820650905>3.0.co;2-#

Cited by 66 publications

(32 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The COPP regimen (cyclophosphamide, vincristine, procarbazine, and prednisolone), which includes the gonadotoxic agent cyclophosphamide in addition to procarbazine, is associated with even more marked gonadal dysfunction. Charak et al [11] found azoospermia in all 92 patients following treatment with six or more cycles of COPP, along with significant rises in gonadotrophin levels compared with pretreatment values. The median followup in this study was 6 years, with 17% of patients having been treated more than 10 years previously, suggesting that germinal epithelial failure is likely to be permanent.…”

Section: Chemotherapysupporting

confidence: 89%

“…Following chemotherapy for Hodgkin's disease with procarbazine-containing regimens and high-dose radiotherapy, recovery to oligo-or normospermia is uncommon. Testicular biopsies taken after standard chemotherapy (MVPP and COPP) for Hodgkin's disease have shown complete germinal aplasia with a Sertoli-cell only pattern [6,11,33,48,49]. Recent reports have been made of the isolation of mature sperm in the testicular parenchyma of some men with biopsy evidence of Sertolicell only, suggesting that even in this situation there may be small foci of spermatogenesis [50].…”

Section: Hormonal Manipulationmentioning

confidence: 97%

See 1 more Smart Citation

Fertility preservation and management of gonadal failure associated with lymphoma therapy

Howell¹,

Shalet

2002

Curr Oncol Rep

View full text Add to dashboard Cite

Treatment with cytotoxic chemotherapy and radiotherapy is associated with significant gonadal damage in men and women. The likelihood of gonadal failure following cytotoxic chemotherapy is dependent on the drug and dose, and in women there is also an effect of age at treatment. Irradiation of the testes or ovaries, either directly or indirectly, is also a significant cause of gonadal dysfunction, and the potential to recover from damage is clearly related to the radiation dose received. Several methods of preserving gonadal function during potentially sterilizing treatment have been considered. At present, sperm banking remains the only proven method in men, although hormonal manipulation to enhance recovery of spermatogenesis and cryopreservation of testicular germ cells are possibilities for the future. Transposition of the ovaries to allow better shielding during radiotherapy is of use in some women, and the prospect of cryopreservation and reimplanation of ovarian tissue appears to be promising.

show abstract

Section: Chemotherapysupporting

confidence: 89%

Section: Hormonal Manipulationmentioning

confidence: 97%

Fertility preservation and management of gonadal failure associated with lymphoma therapy

Howell¹,

Shalet

2002

Curr Oncol Rep

View full text Add to dashboard Cite

show abstract

“…DNA damage rates in sperm are higher in infertile individuals (Irvine et al 2000), patients subjected to cancer therapies (Charak et al 1990, Kenney et al 2001, men who smoke (Zenzes et al 1999, Zenzes 2000 and also possibly in older men (Wyrobek et al 2006). Concerns have been expressed that using sperm with damaged DNA for intracytoplasmic sperm injection (ICSI) could have a long-term effect on the health of the children born to subfertile couples (Gosden et al 2003).…”

Section: Introductionmentioning

confidence: 99%

A single, mild, transient scrotal heat stress causes DNA damage, subfertility and impairs formation of blastocysts in mice

Paul¹,

Murray²,

Spears³

et al. 2008

Reproduction

235

168

View full text Add to dashboard Cite

Infertility represents a major clinical problem and 50% of cases are attributable to the male partner. Testicular function is temperature dependent, and in both man and mouse the position of the testes in the scrotum ensures that they are kept at between 2 and 8 8C below core body temperature. We used a mouse model to investigate the impact of a single, transient, mild, scrotal heat stress (38, 40 or 42 8C for 30 min) on testicular function, sperm DNA integrity and embryo survival. We detected temperature-dependent changes in testicular architecture, number of apoptotic cells and a significant reduction in testis weight 7 and 14 days after heat stress at 42 8C. We report for the first time that DNA strand breaks (g-H2AX-positive foci) were present in spermatocytes recovered from testes subjected to 40 or 42 8C. Fertility of heat-stressed males was tested 23-28 d after treatment (sperm at this time would have been spermatocytes at time of heating). Paternal heat stress at 42 8C resulted in reduced pregnancy rate, placental weight and litter size; pregnancies from the 40 8C group had increased resorptions at e14.5. Abnormalities in embryonic development were detected at e3.5 and in vitro fertilisation with sperm recovered 16 h or 23 d after scrotal stress at 42 8C revealed a block in development between the 4-cell and blastocyst stages. This study has provided evidence of temperature-dependent effects on germ cell DNA integrity and highlighted the importance of an intact paternal genome for normal embryo development. Reproduction (2008) 136 73-84

show abstract

“…Following treatment more than 91% continued to have azoospermia at a follow-up of five years, which is similar to other studies 9,12 (Table 3). The effect of cyclophosphamide and procarbazine combination on sperm count and hormone levels (FSH) was significant.…”

Section: Valuesmentioning

confidence: 99%

Return of Normal Testicular Activity in Cured Patients of Lymphoma

Kuchay¹,

Paul²,

Nabi³

2016

jemds

View full text Add to dashboard Cite

BACKGROUNDFor young patients cured of lymphoma, the major concern is gonadal dysfunction with impaired reproductive capacity. This has a bearing on the social well-being and self-esteem of these otherwise cured patients. Pretreatment infertility is a significant problem in males having Hodgkin's lymphoma. This already compromised testicular activity further deteriorates with chemotherapy and radiotherapy. Recovery of testicular activity after cure and subsequent cessation of treatment reaches a peak at around 5 years. Further longer follow-up beyond five years has demonstrated varying results of improvement and return of normal testicular activity. AIMTo determine impact of treatment and long-term follow-up on return of normal testicular activity in patients cured of lymphoma. MATERIALS AND METHODSProspective study comprising 30 newly diagnosed male patients with histopathological diagnosis of lymphoma. Semen analysis, serum FSH and LH levels were determined pretreatment, immediately after completion of therapy and yearly till 20 years (From 1994(From -2014. Pretreatment, immediate post-treatment, 5-year and 20-year observations are evaluated for presentation. RESULTSPretreatment infertility was present in 13.47% of patients. After completion of treatment, 77.50% developed azoospermia. However, after initial follow-up of 5 years, percentage of normospermic patients returned to 42.93%, recovery being better in patients of age less than 30 years. Reevaluation of 18 cured patients at a further 20 years follow-up demonstrated no further significant recovery. CONCLUSIONThe effect of cyclophosphamide and procarbazine containing chemotherapy is significant compared to the patients who received combinations without procarbazine. Initial recovery of testicular functions achieved at 5 years was less likely to improve significantly even after a prolonged follow-up period of 20 years. KEYWORDSHodgkin's Lymphoma, Non-Hodgkin's Lymphoma, Semen Analysis, FSH, LH. HOW TO CITE THIS ARTICLE:Kuchay S, Paul ZA, Nabi M. Return of normal testicular activity in cured patients of lymphoma.

show abstract

Testicular dysfunction after cyclophosphamide‐vincristine‐procarbazine‐prednisolone chemotherapy for advanced hodgkin's disease a long‐term follow‐up study

Cited by 66 publications

References 17 publications

Fertility preservation and management of gonadal failure associated with lymphoma therapy

Fertility preservation and management of gonadal failure associated with lymphoma therapy

A single, mild, transient scrotal heat stress causes DNA damage, subfertility and impairs formation of blastocysts in mice

Return of Normal Testicular Activity in Cured Patients of Lymphoma

Contact Info

Product

Resources

About