Gonadal development and function after immature testicular tissue banking as part of high-risk gonadotoxic treatment.

Autor: Braye A; Department of Reproduction, Genetics and Regenerative Medicine (RGRG), Biology of the Testis (BITE), Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium., Delgouffe E; Department of Reproduction, Genetics and Regenerative Medicine (RGRG), Biology of the Testis (BITE), Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium., van der Werff Ten Bosch J; Department of Pediatrics, Division of Pediatric Oncology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan, Brussels, Belgium., Gies I; Department of Pediatrics, Division of Pediatric Endocrinology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan, Brussels, Belgium., Ferster A; Department of Hemato-Oncology, Université Libre de Bruxelles (ULB), Hôpital Universitaire des Enfants Reine Fabiola (HUDERF), Jean Joseph Crocqlaan, Brussels, Belgium., Goossens E; Department of Reproduction, Genetics and Regenerative Medicine (RGRG), Biology of the Testis (BITE), Vrije Universiteit Brussel (VUB), Laarbeeklaan, Brussels, Belgium.
Jazyk: angličtina
Zdroj: Pediatric blood & cancer [Pediatr Blood Cancer] 2023 Aug; Vol. 70 (8), pp. e30370. Date of Electronic Publication: 2023 May 07.
DOI: 10.1002/pbc.30370
Abstrakt: Background: Experimental fertility preservation programs have been started to safeguard the future fertility of prepubertal and pubertal males requiring high-risk gonadotoxic treatment protocols. However, long-term follow-up studies evaluating the effects on their gonadal development and function related to the testicular biopsy procedure are rather limited.
Design: This two-center follow-up study (between 2002 and 2020) evaluated the gonadal development and function of a cohort of 59 prepubertal and pubertal males who have been offered immature testicular tissue banking (TTB) prior to conventional high-risk chemo- and/or radiotherapy (HR-C/R) or conditioning therapy before hematopoietic stem cell transplantation (CT-HSCT). The aim is to investigate the long-term impact of the testicular biopsy procedure and the high-risk gonadotoxic treatment. Testicular growth and the reproductive hormones luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone (T), and inhibin B (INHB) were analyzed after treatment completion, and compared between males accepting TTB and those refusing TTB (control) as well as between HR-C/R and CT-HSCT treatment protocols.
Results: Of the 59 prepubertal and pubertal males included, 25 were treated by HR-C/R and 34 required CT-HSCT. TTB was accepted for 39 males and refused for 20 males. Most patients were prepubertal at diagnosis (85%), at TTB (79%), and at treatment completion (76%), and pubertal or postpubertal at their last follow-up visit (66%). After 5.0 (1.0-13.0) years post treatment, most patients show normal testicular volumes (83%) and normal LH (89%), FSH (87%), T (87%), and INHB (79%) serum levels. The testicular biopsy procedure did not have an effect on testicular growth, LH, FSH, T, and INHB. Significantly more small postpubertal testicular volumes (p = .0278) and low INHB serum levels (p = .0130) were recorded after CT-HSCT, especially after myeloablative conditioning.
Conclusion: The clinical follow-up data demonstrate no effect related to the biopsy procedure, but a substantial risk for impaired gonadal development after high-risk gonadotoxic treatment, in particular myeloablative CT-HSCT. Longer follow-up studies with a larger study population are needed to confirm these preliminary findings.
(© 2023 The Authors. Pediatric Blood & Cancer published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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