Low incidence of testicular failure in boys treated for acute leukemia

Boys with acute leukemia who are treated with total body and testicular irradiation have a low incidence of testicular recurrence, according to a report in the August 15th issue of Cancer.

At the Duke University Medical Center in Durham, North Carolina, Dr. Brian P. Quaranta and colleagues conducted a follow-up study of 131 boys who were treated between 1991 and 1999 with stem cell transplantation. The patient underwent total body irradiation with testicular boost, total body irradiation without testicular boost or chemotherapy alone. The boys were undergoing treatment for either acute myeloid leukemia or acute lymphocytic leukemia.With a median follow-up of 26.5 months from bone marrow transfusion, the researchers found that two of the boys had developed primary testicular failure after total body irradiation with testicular boost followed by an umbilical cord blood transplantation. “The first patient had acute lymphocytic leukemia, did not engraft, and was rescued with autologous cells,” the authors said. This patient’s testicular disease developed 15 months afterward. He did not survive. “The second patient had Philadelphia-chromosome positive acute lymphocytic leukemia and developed a testicular recurrence 26 months after stem cell transplantation,” the researchers added. This patient underwent orchiectomy and received additional testicular irradiation and chemotherapy. More than 3 years after testicular failure, he remained in remission.Overall, among the boys treated with total body irradiation and testicular irradiation who survived at least 1 year, the incidence of testicular failure was 4.2%, the investigators said.The boys who received chemotherapy alone had no primary testicular failures.”Boys with acute myeloid leukemia or acute lymphocytic leukemia had a low incidence of primary testicular failure when they were treated with total body irradiation plus a testicular boost or with chemotherapy alone,” the authors conclude.(Source: Cancer 2004;101:845-850: Reuters Health News: Oncolink: September 2004.)