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Post-Transplant Events

Gonadal shielding to irradiation is effective in protecting testicular growth and function in long-term survivors of bone marrow transplantation during childhood or adolescence

Bone Marrow Transplantation volume 39, pages 483–490 (2007)Cite this article

Abstract

An increasing number of long-term surviving bone marrow transplantation (BMT) recipients have recovered from their primary disease but are at risk of developing failure of endocrine organs. We investigated 30 recipients who underwent allogeneic BMT during childhood or adolescence. Testicular growth and function were evaluated by serial measurement of testicular volume, basal luteinizing hormone (LH), basal follicle-stimulating hormone (FSH) and testosterone levels and by gonadotropin-releasing hormone (GnRH) provocative test. Puberty started spontaneously in all patients. However, all except four patients had normal testosterone levels with elevated LH, indicating partial Leydig cell dysfunction. Standard deviation scores of testicular volume at last evaluation were statistically lower in those who had received irradiation without gonadal shield compared to those with (−2.04±0.45 vs −0.30±1.17, respectively, P<0.005), suggesting damage of testicular germinal epithelium owing to gonadal irradiation. Serial measurement of testicular volume showed a tendency of growth to stop at 10 ml in those without gonadal shield. Among the 30 patients, only one patient has fathered a child after reaching spontaneous puberty. These results suggest that gonadal shield is effective to protect testicular growth and function, although the attainment of fertility is difficult to achieve.

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Acknowledgements

We thank all the medical staff in Tokai University Hospital for patient care. This study was partially supported by a Research Grant on Human Genome and Tissue Engineering from the Ministry of Health, Welfare and Labor.

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Authors and Affiliations

  1. Department of Pediatrics, Tokai University School of Medicine, Kanagawa, Japan

    H Ishiguro, Y Yasuda, Y Tomita, T Shinagawa, T Shimizu, T Morimoto, K Hattori, M Matsumoto, H Inoue, H Yabe, M Yabe, O Shinohara & S Kato

  2. Department of Pediatrics, University of Tsukuba, Ibaraki, Japan

    T Shimizu

  3. Department of Cell Transplantation & Regenerative Medicine, Tokai University School of Medicine, Kanagawa, Japan

    S Kato

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  1. H Ishiguro
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  2. Y Yasuda
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Correspondence to H Ishiguro.

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Ishiguro, H., Yasuda, Y., Tomita, Y. et al. Gonadal shielding to irradiation is effective in protecting testicular growth and function in long-term survivors of bone marrow transplantation during childhood or adolescence. Bone Marrow Transplant 39, 483–490 (2007). https://doi.org/10.1038/sj.bmt.1705612

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