MP38-03 EFFECTS OF HAEMATOLOGICAL MALIGNANCY TREATMENT TO FERTILITY IN YOUNG MALES

Abstract

INTRODUCTION AND OBJECTIVE: Haematological malignancies are one of the prominent groups of cancers effecting adolescents and young adults. The side-effects of cancer therapies to fertility in this patient group is poorly understood by clinicians. Consequently, patients are left feeling confused and unsatisfied after treatment due to inadequate physician counselling. It is therefore the aim of this review to provide information on the risks to fertility from common blood cancer treatments. METHODS: Three databases (Medline via PUBMED, SCOPUS, Cochrane Library) were searched for randomized-controlled trials, non-randomized studies of interventions (NRSIs), and other observational studies. This review included male patients at their most fertile age, taken to be 13-51 years old and diagnosed with haematological malignancies. Markers reflecting gonadal function were monitored to identify changes to male fertility. These included sperm characteristics such as sperm count and morphology alongside the sex hormones testosterone and FSH. Analysis of studies was performed following a satisfactory risk of bias assessment using the Risk Of Bias In Non-randomized Studies - of Interventions (ROBINS) tool. RESULTS: After relevant studies were excluded from the initial search seven studies featuring 1482 patients with haematological malignancies were included for analysis. 1353 of the patients had Hodgkin’s Lymphoma and patients featuring ABVD (n=4) and BEACOPP (n=3) treatment regimes were reviewed. Patients treated with BEACOPP were more prone to oligospermia and those who received fewer cycles had a greater likelihood of sperm production recovering. Evidence shows that both ABVD and BEACOPP impair male fertility, but the use of BEACOPP and an increased number of cycles is associated with greater impairment. CONCLUSIONS: Substantial evidence identifies the risks to fertility from ABVD and BEACOPP in Hodgkin lymphoma patients to help guide clinicians and patients in making appropriate fertility sparing decisions (Figure 1). This review also identifies a significant gap in literature necessitating high-quality studies to accurately record fertility changes in respond to cancer treatment in males.Source of Funding: None