Discoveries
Long-term fertility problems found in boys treated with high-dose chemotherapy
Lisa Diller, M.D.
It has long been known that men treated with chemotherapy medications known as alkylating agents experience declines in fertility. But what about boys who receive the agents before entering puberty?
A study by researchers at Dana-Farber and Children's Hospital Boston has found that young males with sarcomas — cancers of the bone, cartilage, or certain muscles — who receive high doses of the medications are likely to experience irreversible fertility problems as adults.
The study, part of a growing effort to explore the long-term effects of cancer treatment, was published by investigators at the David B. Perini, Jr. Quality of Life Clinic at Dana-Farber.
Led by Lisa Diller, M.D., medical director of the Perini Clinic, and lead author Lisa Kenney, M.D., M.P.H., the study involved 17 men who had been treated with alkylating agents as children. The researchers found that 10 of them (60 percent of the entire group) had no sperm production, five (or 29 percent) had reduced sperm production, and only two (or 12 percent) had normal sperm counts. All those who had been treated prior to puberty had abnormalities in their semen, a finding that contradicts doctors' long-held belief that treatment with these medications prior to puberty was safe for the male reproductive organs.
"It's important that parents of young patients be informed about the potential for long-term side effects on fertility."
— Lisa Diller, M.D.
"The results indicate not only that exposure to alkylating agents before puberty is not protective, but also that the risk of infertility increases with higher doses of the therapy," Diller says. "It's important that parents of young patients be informed about the potential for long-term side effects on fertility."
Dana-Farber and Children's researchers are currently studying ways of lessening the chances that such patients will have reduced sperm counts later in life. For patients who have already reached puberty, spermbanking prior to treatment is being investigated to increase their future chances of fathering children.
This study was published in the Feb.1, 2001, issue of Cancer.
