INRS-Centre Armand-Frappier Santé Biotechnologie, Laval, Quebec, Canada.
Department of Pharmacology and Therapeutics, McGill University, Montreal, Quebec Canada.
PLoS One. 2019 Dec 19;14(12):e0226262. doi: 10.1371/journal.pone.0226262. eCollection 2019.
Childhood cancer survivors (CCS) are more likely than siblings to report low sperm count and to use assisted reproductive technologies. Yet, it is still unclear if the sperm produced many years after remission of cancer display DNA and chromatin damage linked to male infertility and poor embryo development. As well, the importance of the age at diagnosis in relation to puberty is poorly understood. In this pilot study, we compared reproductive parameters and sperm damage from adult survivors of childhood leukemia and lymphoma, sub-divided into those diagnosed before or after puberty, to men with no history of cancer. Our data indicate that CCS, independently of the age of diagnosis, have a high risk of low sperm count and when sperm are present, chances of DNA and chromatin abnormalities appear similar to those seen in the general population. Exposure to alkylating agents is correlated with low sperm count whereas exposure to anthracyclines, and doxorubicin in particular, could have long-term consequences on sperm integrity. This study highlights the need for further research on fertility among male CCS and the importance of informing families about the potential long-term impact of chemotherapy on male fertility regardless of age at diagnosis.
儿童癌症幸存者（CCS）比其兄弟姐妹更有可能报告精子数量低，并使用辅助生殖技术。然而，癌症缓解多年后产生的精子是否显示与男性不育和胚胎发育不良相关的 DNA 和染色质损伤仍然不清楚。此外，与青春期相关的诊断年龄的重要性也知之甚少。在这项初步研究中，我们将青春期前或青春期后诊断为儿童白血病和淋巴瘤的成年幸存者的生殖参数和精子损伤与无癌症病史的男性进行了比较。我们的数据表明，CCS 无论诊断年龄如何，都有精子数量低的高风险，而且当存在精子时，DNA 和染色质异常的可能性与一般人群相似。暴露于烷化剂与精子数量低有关，而暴露于蒽环类药物，特别是阿霉素，可能对精子完整性有长期影响。这项研究强调了需要进一步研究男性 CCS 的生育能力，以及无论诊断年龄如何，都要告知家庭化疗对男性生育能力的潜在长期影响的重要性。
