Testicular Function in Boys after Chemotherapy for Acute Lymphoblastic Leukemia

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Abstract
Fourteen boys with acute lymphoblastic leukemia who had been treated with combination chemotherapy (prednisone, vincristine, methotrexate, and 6-mercaptopurine) were followed prospectively to assess the effect of this regimen on gonadal function. At the start of therapy, nine patients were prepubertal, four were intrapubertal, and one was sexually mature. The interval between discontinuation of chemotherapy and the most recent endocrine evaluation ranged from two months to 8 1/2 years (median, 5 1/2 years). Throughout the follow-up period, all patients had normal testicular function as determined by Tanner staging at physical examination and by serum gonadotropin and testosterone levels. Semen samples from six patients were unremarkable except for one sperm count that fell in the low-normal range. These results indicate that the administration of antileukemic chemotherapy can be compatible with normal gonadal development. (N Engl J Med. 1981; 304:1121–4.)