Postpubertal evaluation of gonadal function following cyclophosphamide therapy before and during puberty

Lentz, Richard D.; Bergstein, Jerry M.; Steffes, Michael W.; Brown, David R.; Prem, Konald A.; Michael, Alfred F.; Vernier, Robert L.

doi:10.1016/s0022-3476(77)81305-x

Cited by 101 publications

(30 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This can be explained by the lower total radiation dose used in single-fraction TBI, but there is also evidence that fractionation of one dose may lead to longer sterile periods in man [1]. Variations in the exposure to alkylating agents prior to BMT could be responsible for this absence of testicular recovery, as the cumulative dosage rather than the daily dosage is the most important factor determining gonadotoxicity of cyclophosphamide, also used in the preparative regimens [14,22,26]. In view of the known vulnerability of germinal epithelium to irradiation and the elevated FSH levels, we expect most of the male patients to be infertile.…”

Section: Discussionmentioning

confidence: 99%

Pubertal development and growth after total-body irradiation and bone marrow transplantation for haematological malignancies

Bakker¹,

Massa

Oostdijk³

et al. 2000

European Journal of Pediatrics

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Pubertal development and growth after total-body irradiation and bone marrow transplantation for haematological malignancies

Bakker¹,

Massa

Oostdijk³

et al. 2000

European Journal of Pediatrics

View full text Add to dashboard Cite

show abstract

“…However, the long-term ability to suppress a relapse is likely only for cyclophosphamide. Among the three immunosuppressants, cyclophosphamide and chlorambucil have gonadal toxicity which seems to be dose dependent [20,21]. Further administration of these drugs should be avoided, especially in pubertal boys, in view of the cumulative toxicity.…”

Section: Discussionmentioning

confidence: 99%

Long-term effects of immunosuppressants in steroid-dependent nephrotic syndrome

Takeda

Ohgushi

Niimura

et al. 1998

Pediatric Nephrology

View full text Add to dashboard Cite

In order to elucidate long-term effects of immunosuppressants, we studied 60 children with steroid-dependent nephrotic syndrome who were treated with three immunosuppressants: cyclophosphamide (n=34), chlorambucil (n=11), and cyclosporin A (n=15). Each relapse before and after the administration of immunosuppressants was evaluated longitudinally in terms of the relapse-free period and the maintenance dose of prednisolone required. The median follow-up period after immunosuppressants was 5.2 years (range 0.5-20.3 years). The relapse-free period was significantly longer in all groups after the initiation of immunosuppressants. However, the relapse-free period after subsequent relapses as compared with the previous relapse was longer in the cyclophosphamide group, similar in the chlorambucil group, and shorter in the cyclosporin A group. The prednisolone dosage at relapse was reduced in subsequent relapses after cyclophosphamide and chlorambucil treatment, but tended to be higher in later relapses after the initiation of cyclosporin A. These findings suggest that the effects of cyclophosphamide are long lasting, while those of chlorambucil and cyclosporin A are of short duration. Children who relapse after cyclosporin A treatment may experience a worse relapsing course.

show abstract

“…This effect may to some extent be dose related and has been observed in males treated before as well as during and after puberty [3, 38,[40][41][42][43]. The concept that the prepubertal testis may be less susceptible remains to be proven in humans; some studies suggest a higher risk in the sexually more mature patients [33], others show no age relationship [35,39,42].…”

Section: Discussionmentioning

confidence: 99%

Reproduction following treatment for childhood leukemia: A population‐based prospective cohort study of fertility and offspring

Nygaard¹,

Clausen

Siimes³

et al. 1991

Med. Pediatr. Oncol.

View full text Add to dashboard Cite

Of all children diagnosed with leukemia in Denmark, Finland, Iceland, Norway, and Sweden, 981 had discontinued therapy before 1985 and had been followed up annually after cessation of therapy. Progeny was registered and fertility evaluated among survivors who passed age 18 years without a relapse (n = 299). By April 1989, 48 offspring were registered, one of whom had congenital anomalies. This was no more than expected from the incidence of birth defects in the general population. No childhood malignancies or genetic diseases have so far been diagnosed in the progeny. In the study group, none of the 19 female and 8 male survivors of myeloid leukemias had become parents, and only 4 fathers were reported among the 131 male survivors of acute lymphoblastic leukemia (ALL). However, 23 of the 149 females treated for ALL had delivered 41 children. Fertility was measured as cumulative rates of first birth by maternal age. In a Cox regression analysis, cases who had received prophylactic radiation of the central nervous system (CNS) had a lower first birth rate than those without radiation (rate ratio 0.39, 95% CI 0.15-1.00), indicating that doses of 18-24 Gy to the brain may possibly be a risk factor. By using the Norwegian birth cohort of 1966 as a control group, matching the median year of birth for the study subjects, the group of female ALL survivors as a whole was as likely as the general female population to have given birth up to the age of 23. The first generation of females successfully treated for childhood ALL seems to have a nearly normal reproductive pattern during young adulthood, without increased risk of congenital anomalies in the offspring. However, cranial radiation as CNS prophylaxis may possibly impair subsequent reproduction.

show abstract

Postpubertal evaluation of gonadal function following cyclophosphamide therapy before and during puberty

Cited by 101 publications

References 41 publications

Pubertal development and growth after total-body irradiation and bone marrow transplantation for haematological malignancies

Pubertal development and growth after total-body irradiation and bone marrow transplantation for haematological malignancies

Long-term effects of immunosuppressants in steroid-dependent nephrotic syndrome

Reproduction following treatment for childhood leukemia: A population‐based prospective cohort study of fertility and offspring

Contact Info

Product

Resources

About