Impact of cyclophosphamide on long-term reduction in sperm count in men treated with combination chemotherapy for ewing and soft tissue sarcomas

Meistrich, Marvin L.; Wilson, Gene; Brown, Barry W.; Cunha, Miguel F.; Lipshultz, Larry I.

doi:10.1002/1097-0142(19921201)70:11<2703::aid-cncr2820701123>3.0.co;2-x

Cited by 230 publications

(123 citation statements)

References 29 publications

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“…Meistrich et al (41) showed that a cumulative dose of IV CYC Ͼ7.5 gm/m 2 was associated with azoospermia. Our findings are in accordance with those of previous studies in cancer and nephrotic syndrome that showed a decrease in spermatozoa production following IV CYC treatment, due to dysfunction of the germinal epithelium (7,8).…”

Section: Discussionmentioning

confidence: 99%

Gonad evaluation in male systemic lupus erythematosus

Soares¹,

Borba²,

Bonfá³

et al. 2007

Arthritis & Rheumatism

103

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Objective. To assess gonad function in male patients with systemic lupus erythematosus (SLE).Methods. Thirty-five consecutive male patients with SLE according to the criteria of the American College of Rheumatology were prospectively evaluated for demographic and clinical features as well as previous and current treatment. Patients underwent urologic evaluation and testicular Doppler ultrasound. We obtained a hormone profile and performed a semen analysis including morphology and testing for the presence of antisperm antibodies. Patients were compared with 35 age-matched healthy controls.Results. Compared with controls, SLE patients had lower median testicular volumes in both testes, a lower median total sperm count, and a lower median total motile sperm count. The mean sperm volume and percentage of normally formed sperm were lower in SLE patients than in controls. Since all SLE patients had semen alterations, they were further subdivided into 2 groups according to the severity of these abnormalities (group 1, with teratozoospermia [n ‫؍‬ 18], and group 2, with azoospermia or teratozoospermia in combination with oligozoospermia and/or asthenozoospermia [n ‫؍‬ 17]). The frequency of treatment with intravenous cyclophosphamide (IV CYC) after the first ejaculation was higher in group 2 than in group 1. The median testicular volumes measured by ultrasound in both testicles were lower in group 2 than in group 1. Follicle-stimulating hormone levels were higher in group 2 than in group 1. The overall frequency of antisperm antibodies in SLE patients was 40%. The apparent higher frequency of antisperm antibodies in group 1 than in group 2 did not reach significance.Conclusion. SLE patients have a high frequency of sperm abnormalities associated with reduced testicular volume. Postpubertal IV CYC treatment was the major factor in potential permanent damage to the testes.

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Section: Discussionmentioning

confidence: 99%

Gonad evaluation in male systemic lupus erythematosus

Soares¹,

Borba²,

Bonfá³

et al. 2007

Arthritis & Rheumatism

103

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“…Treatment of LN, in contrast to treatment of NS, employs gonadotoxic dose limits measured in gram per square meter (g/m 2 ) [8], which is the standard of care in pediatric oncology [15]. As discussed below, the recommended dosing limit in male patients is 7.5 g/m 2 based on sperm count recovery [8].…”

Section: Dosing Recommendations For Treatment With Cpomentioning

confidence: 99%

“…As discussed below, the recommended dosing limit in male patients is 7.5 g/m 2 based on sperm count recovery [8]. While this dosing limit is also accepted for the female patient, the protective effect of age allows younger patients to tolerate a higher cumulative dose, up to 10-15 g/m 2 [10].…”

Section: Dosing Recommendations For Treatment With Cpomentioning

confidence: 99%

“…In a 1992 study, Meistrich et al followed sperm counts through the treatment course with CPO and demonstrated a drop from normal sperm count levels prior to treatment to azoospermic levels after 12 months of therapy [8]. Amenorrhea secondary to CPO therapy was also noted in the early 1970s, with loss of menstrual cycles in 18 of 34 previously menstruating women who were treated with CPO for glomerulonephritis, nephropathy, and lupus nephritis (LN) [8,9]. The risk of sustained amenorrhea has been shown to develop in a dose-dependent and age-dependent pattern, with older patients and patients receiving higher cumulative doses at an increased risk of developing amenorrhea [10].…”

Section: Introductionmentioning

confidence: 99%

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Fertility preservation in patients receiving cyclophosphamide therapy for renal disease

et al. 2014

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Cyclophosphamide continues to have an important role in the treatment of renal disease, including nephrotic syndrome and lupus nephritis, despite known complications of gonadotoxicity and potential infertility in both male and female patients. It is important that the physician recommending this therapy mitigates the effect of the drug on fertility by adhering to recommendations on dosing limits and offering fertility-preserving strategies. In addition to wellestablished methods, such as sperm banking and embryo cryopreservation, advances in reproductive technology have yielded strategies such as oocyte cryopreservation, resulting in more fertility-preserving options for the pediatric patient. Despite these advances, there continues to be a significant barrier to referral and access to sperm banks and fertility specialists. These issues are further complicated by ethical issues associated with the treatment of pediatric patients. In this review we explore the development of recommended dosing limits and include a discussion of the available fertility-preserving methods, strategies for increasing access to fertility specialists, and the ethical considerations facing the pediatric healthcare provider.

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“…Complete destruction by the alkylating agent cyclophosphamide of primordial and primary follicles is achieved at lower doses in prepubertal mice than in adult mice (Shiromizu et al, 1984;Plowchalk & Mattison, 1991). In young men, the use of multiple chemotherapy regimens is associated with a risk of permanent sterility, and the cumulative dose of cyclophosphamide has been shown to be an important determinant of recovery to normospermic levels after azoospermia (Meistrich et al, 1992).…”

Section: ) Antineoplastic Agentsmentioning

confidence: 99%

Expressing urine from a gel disposable diaper for biomonitoring using phthalates as an example

Liu

Xia

Guo

et al. 2012

J Expo Sci Environ Epidemiol

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The urinary metabolites of phthalates are well-accepted exposure biomarkers for adults and children older than 6 years but are not commonly used for infants owing to non-convenient sampling. In the light of this situation, a novel sampling method based on monitoring the urine expressed from the gel diaper was developed. The urine was expressed from the gel absorbent after mixing the absorbent with CaCl2 and then collected by a laboratory-made device; the urinary phthalate metabolites were extracted and cleaned using a solid-phase extraction (SPE) column and analyzed with high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry / mass spectrometry. To evaluate the method's feasibility, the following factors were investigated: the proportion of CaCl2 to gel absorbent, the urination volume variation and the target compounds' deposition bias in the diaper, the matrix blank of the different diaper brands, the storage stabilities and the recoveries of creatinine and phthalate metabolites in the expressed urine. Mono-methyl phthalate, mono-ethyl phthalate, mono-butyl phthalate, mono-benzyl phthalate, mono-2-ethylhexyl phthalate and mono-2-ethyl-5-oxohexyl phthalate were involved. 70-80% of the urine can be expressed from the diaper, and the expressed spiking recoveries and the limit of detection of mono-phthalates ranged from 88.5-115% and 0.21-0.50 ng/ml. The method was applied to measure phthalate metabolites in 65 gel diaper samples from 15 infants, and the pilot data suggests the infants are commonly exposed to phthalates. In summary, the method for monitoring of infant exposure to phthalates is sound and validated, and the potential health effects from the vulnerable infants' exposure to phthalates should be concerned.39th Scientific Research Foundation for the Returned Overseas Chinese Scholars (SRF for ROCS); Hundred Talent Program of Chinese Academy of Sciences (CAS); CAS/SAFEA International Partnership Program for Creative Research Teams [KZCX2-YW-T08

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Impact of cyclophosphamide on long-term reduction in sperm count in men treated with combination chemotherapy for ewing and soft tissue sarcomas

Cited by 230 publications

References 29 publications

Gonad evaluation in male systemic lupus erythematosus

Gonad evaluation in male systemic lupus erythematosus

Fertility preservation in patients receiving cyclophosphamide therapy for renal disease

Expressing urine from a gel disposable diaper for biomonitoring using phthalates as an example

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