BONE MARROW TRANSPLANTATION OR HYDROXYUREA FOR SICKLE CELL ANEMIA: Long-Term Effects on Semen Variables and Hormone Profiles

Ten male subjects affected by sickle cell anemia (SCA) were studied to evaluate the long-term effects of therapies on their fertility. Their ages ranged from 18 to 34 years (median: 32 years). Four subjects were treated by hydroxyurea (HU) and 6 by hematopoietic stem cell transplantation (HSCT). The median follow-up after HU initiation and HSCT was 10.5 years (range: 8–15 years) and 15.5 years (range: 8–21 years), respectively. Three of the 6 in the HSCT group and two of the 4 in the HU group were azoospermic. One HSCT subject had normal semen and hormone variables, showing that normal fertility can occasionally be expected after transplantation in SCA. The remaining 4 patients (2 HSCT and 2 HU) were oligozoospermic. With regard to HU, semen impairment appears to be related to the duration of treatment. To draw general conclusions, further research with a large number of patients treated since childhood with HU or HSCT is warranted.

[1]  C. Nahoum,et al.  Semen Analysis in Sickle Cell Disease , 2009, Andrologia.

[2]  A. Fischer,et al.  Long-term results of related myeloablative stem-cell transplantation to cure sickle cell disease. , 2007, Blood.

[3]  L. Isola,et al.  Graft Versus Host Disease After Stem Cell Allotransplantation With Low-Dose Total Body Irradiation, Fludarabine, and Antithymocyte Globulin , 2007, Transplantation.

[4]  C. Heinrichs,et al.  Children With Sickle Cell Disease: Growth and Gonadal Function After Hematopoietic Stem Cell Transplantation , 2007, Journal of pediatric hematology/oncology.

[5]  J. Donnez,et al.  Spermatogonial survival after cryopreservation and short-term orthotopic immature human cryptorchid testicular tissue grafting to immunodeficient mice. , 2007, Human reproduction.

[6]  K. Jahnukainen,et al.  Methods of cryopreservation of testicular tissue with viable spermatogonia in pre-pubertal boys undergoing gonadotoxic cancer treatment. , 2007, Human reproduction.

[7]  A. Grigg Effect of hydroxyurea on sperm count, motility and morphology in adult men with sickle cell or myeloproliferative disease , 2007, Internal medicine journal.

[8]  J. Masood,et al.  Hydroxyurea therapy: a rare cause of reversible azoospermia , 2007, International Urology and Nephrology.

[9]  S. Donfield,et al.  Effect of myeloablative bone marrow transplantation on growth in children with sickle cell anaemia: results of the multicenter study of haematopoietic cell transplantation for sickle cell anaemia , 2007, British journal of haematology.

[10]  P. Byrns,et al.  Opportunities to improve outcomes in sickle cell disease. , 2006, American family physician.

[11]  J. Scott,et al.  Long-term hydroxyurea therapy for infants with sickle cell anemia: the HUSOFT extension study. , 2005, Blood.

[12]  G. Buchanan,et al.  Expanding the role of hydroxyurea in children with sickle cell disease. , 2004, The Journal of pediatrics.

[13]  C. Quinn,et al.  Survival of children with sickle cell disease. , 2004, Blood.

[14]  A. Gourdin,et al.  Hydroxyurea treatment for sickle cell disease: impact on haematopoietic stem cell transplantation's outcome , 2004, Bone Marrow Transplantation.

[15]  R. Ware,et al.  Sustained long-term hematologic efficacy of hydroxyurea at maximum tolerated dose in children with sickle cell disease. , 2004, Blood.

[16]  C. Vermylen Hematopoietic stem cell transplantation in sickle cell disease. , 2003, Blood reviews.

[17]  K. Whitney,et al.  Repeated testicular infarction in a patient with sickle cell disease: a possible mechanism for testicular failure. , 2003, Urology.

[18]  F. Copello,et al.  Semen analysis following allogeneic bone marrow transplantation. Additional data for evidence-based counselling , 2002, Bone Marrow Transplantation.

[19]  Patrick J. Rowe,et al.  Who Manual for the Standardized Investigation, Diagnosis and Management of the Infertile Male , 2000 .

[20]  C. Pegelow,et al.  Impact of bone marrow transplantation for symptomatic sickle cell disease: an interim report. Multicenter investigation of bone marrow transplantation for sickle cell disease. , 2000, Blood.

[21]  O. Modebe,et al.  Effect of age on testicular function in adult males with sickle cell anemia. , 1995, Fertility and sterility.

[22]  M. Stevens,et al.  The mechanism of low testosterone levels in homozygous sickle-cell disease. , 1994, The West Indian medical journal.

[23]  D. Evenson,et al.  Hydroxyurea exposure alters mouse testicular kinetics and sperm chromatin structure , 1993, Cell proliferation.

[24]  R. Mieusset,et al.  Testicular size in infertile men: relationship to semen characteristics and hormonal blood levels. , 1989, British journal of urology.

[25]  R. Scott,et al.  Fertility studies in sickle cell disease: semen analysis in adult male patients. , 1988, International journal of fertility.

[26]  T. Kruger,et al.  Abnormal sperm morphology and other semen parameters related to the outcome of the hamster oocyte human sperm penetration assay. , 1988, International journal of andrology.

[27]  O. Akinyanju,et al.  Testicular dysfunction in men with sickle cell disease. , 1987, Postgraduate medical journal.

[28]  O. Akinyanju,et al.  FERTILITY IN MALES WITH SICKLE CELL DISEASE , 1981, The Lancet.

[29]  D. D. Mcgavi THE ANONYMOUS WHITE TABLET. , 1965, Lancet.

[30]  C. Elie,et al.  Long-term hydroxyurea treatment in children with sickle cell disease: tolerance and clinical outcomes. , 2006, Haematologica.

[31]  G. Garozzo,et al.  Azoospermia in a patient with sickle cell disease treated with hydroxyurea. , 2000, Haematologica.

[32]  S. Kitahara,et al.  Relationship of testicular volume to semen profiles and serum hormone concentrations in infertile Japanese males. , 1998, International journal of fertility and women's medicine.