| Abstract: |
Fertility impairments among men treated during childhood for cancer are known to occur after some, but not all, types of anti-cancer therapy. This is the first study to evaluate proven fertility among adult male survivors of childhood acute lymphoblastic leukemia (ALL). In a retrospective cohort study, proven fertility (ever fathered a pregnancy) was evaluated by self-report among 213 men treated for ALL before age 18 on protocols of the Children's Cancer Group (CCG). Controls (N = 145) were drawn from among male siblings. Overall, with a proportional hazards analysis, proven fertility of male survivors was not different from that of controls (relative fertility (RF) = 0.95, 95% CI 0.63-1.43). However, married men treated before age 10 with high dose (24 cGy) cranial radiotherapy (RT), without spinal RT, had only 9% of the fertility of controls (Relative risk, RR = 0.09, 95% CI 0.01-0.82). High dose cranial RT at older ages was not associated with a statistically significant fertility deficit (RR = 0.56, 95% CI 0.25-1.28). In this first study of proven fertility among men treated for childhood leukemia, the majority of survivors showed no evidence of fertility impairment compared to controls. However, men treated at a young age with high dose cranial RT may have impaired fertility. These results suggest that further investigation of men with these treatments is needed to confirm and extend these findings. © 2003 Wiley-Liss, Inc. |
| Keywords: |
adolescent; adult; cancer survival; child; controlled study; child, preschool; retrospective studies; major clinical study; case-control studies; cancer radiotherapy; radiation dose; radiotherapy, adjuvant; follow up; proportional hazards models; radiotherapy; cohort analysis; age factors; retrospective study; acute lymphoblastic leukemia; childhood cancer; infertility; skull irradiation; self report; survivors; correlation analysis; pregnancy; sex difference; fertility; infertility, male; leukemia, lymphocytic, acute, l1; cohort study; humans; human; male; female; priority journal; article; male childhood leukemia survivors; spinal radiotherapy
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