PURPOSE: Cryopreservation of testicular tissue with subsequent re-implantation after therapy has fertility perseveration potential for pre-pubertal boys with childhood cancer.
We present the histology and the feasibility of testicular tissue procurement for this novel approach.
PATIENTS AND METHODS: We performed a prospective cohort study of boys at significant risk for treatment-associated gonadotoxicity who were eligible for an experimental research protocol between 2008 and 2011. Open testicular biopsy was performed while they were anesthetized for another treatment related procedure. Half of the specimen was reserved for cryopreservation, while the other half was used for research purposes. Semi-thin sections of the biopsy specimens were evaluated for histological features and compared to age-adjusted reference values.
RESULTS: Of the 34 boys who underwent biopsy between March 2008 and October 2011, 29 had solid tumors and 5 underwent hematopoietic stem cell transplantation for benign disease. Of these, 27 had adequate tissue for histologic analysis. The median age of the boys was 8.7 years (IQR=2.2 - 11.5 years). All children had either normal (81.5%) or increased (18.5%) numbers of normal germ cells per tubules for their age. However, 18.5% (5/27) of boys had no evidence of Adult dark (Ad) spermatogonia, and 56% (9/16) of boys had no evidence of primary spermatocytes on biopsy, that would be expected for their age norms. These findings are suggestive of abnormal germ cell maturation.
CONCLUSION: The preliminary histologic findings of abnormal spermatogenesis maturation in testes of pre-pubertal boys with cancer warrants further investigation.
Written by:
Pietzak EJ 3rd, Tasian GE, Tasian SK, Brinster RL, Carlson C, Ginsberg JP, Kolon TF. Are you the author?
Department of Urology (Surgery), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA; Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia, Philadelphia, PA; Institute for Translational Medicine and Therapeutics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; University of Pennsylvania School of Veterinary Medicine, Philadelphia, PA; Cancer Survivorship Program, Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Department of Urology (Surgery), Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA.
Reference: J Urol. 2015 May 29. pii: S0022-5347(15)04103-8.
doi: 10.1016/j.juro.2015.04.117
PubMed Abstract
PMID: 26032139