Follow-up of sperm concentration and motility in patients with lymphoma

TLDR: No predictive tools for post-treatment fertility were found and, therefore, every patient with a lymphoma should have his semen cryopreserved at diagnosis, and the post- treatment sperm outcome was better in patients treated with local irradiation than in those who did not undergo irradiation.

Abstract: distinct, the former being the most common type of lymphoma during the reproductive period of life, with a peak incidence patients with non-Hodgkin's lymphoma or with Hodgkin's may be irreversible, but even if reversed, repair may take as disease during the years 1987-1997 who were referred for long as 20 years (Marmor and Duyck, 1995). New treatment semen cryopreservation. Pretreatment semen analysis, and regimens have increased patient survival substantially, so that hormonal profile were recorded at diagnosis and at least more patients at the reproductive age are living and are 1 year after completion of the treatment, and compared. confronted with infertility. Medical records for disease type, disease stage and treat- Semen cryopreservation is an element of management of ment protocols were related to long-term sperm outcome. lymphoma patients. This is due to the growing awareness of Hormonal concentrations were not predictive of post- physicians and patients themselves regarding the potentially treatment sperm concentration. In patients with localized devastating effect of the disease and its treatment on spermato- disease, initial sperm concentration and motility tended to genesis and future fertility. Patients who had a lymphoma were be preserved, compared with patients with widespread referred to our institute for semen cryopreservation before disease (P 0.016). In Hodgkin's disease patients, treat- commencing treatment. Previously, we studied the effect of ment with the adriamycin, bleomycin, vinblastine and lymphomas on spermatogenesis and assessed pretreatment dacarbazine (ABVD) protocol was superior to the mechlor- sperm quality (Botchan et al., 1997). The present study etamine, vincristine, procarbazine and prednisone with was conducted to determine the factors, either the disease ABV protocol regarding germinal toxicity (P 0.0008). characteristics themselves, or different treatment protocols, The post-treatment sperm outcome was better in patients directly related to semen concentration and motility deteriora- treated with local irradiation than in those who did not tion. In this study we assessed pre- and post-treatment sperm undergo irradiation (P 0.0027). No predictive tools for quality, reflected by sperm motility and concentration. Patients post-treatment fertility were found and, therefore, every were categorized by their disease (HD or NHL), disease stage patient with a lymphoma should have his semen cryopre- and treatment. Staging included distinction between patients served at diagnosis. with and without systemic symptoms: fever, weight loss and