Male reproductive capacity may recover following drug treatment with the L-10 protocol for acute lymphocytic leukemia

Abstract

Six men with acute lymphocytic leukemia (ALL) were studied prospectively to assess the effect of treatment with the L-10 protocol on reproductive capacity. Before therapy three men had fathered children (two, two children; one, three children); the others were sexually mature although no fertility studies had been done prior to or during their treatment. Each patient had a minimum of 3 1/2 years of continuous chemotherapy as part of this study. Semen analysis was done 10 to 52 months (median, 31.5 months) after completion of therapy. One patient had lower than normal sperm concentration but near normal total sperm count and normal motility; the others had a normal sperm concentration and motility. Sperm nuclei were isolated from each sample and analyzed by flow cytometry for resistance to DNA denaturation in situ; all samples had relatively high resistance to denaturation, consistent with a normal, fertile reproductive status. After completion of therapy, one patient fathered a normal child, and a second patient fathered one child with multiple congenital malformations followed by a second child who was normal.