Rapid recovery of spermatogenesis after mitoxantrone, vincristine, vinblastine, and prednisone chemotherapy for Hodgkin's disease

Marvin L. Meistrich, Gene Wilson, Kevin Mathur, Lillian M. Fuller, M. Alma Rodriguez, Peter McLaughlin, Jorge E. Romaguera, Fernando F. Cabanillas, Chul S Ha, Larry I. Lipshultz, Fredrick B. Hagemeister

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Abstract

Purpose: Because the effects of mitoxantrone on human male fertility were unknown, we determined prospectively the effects of three courses of mitoxantrone (Novantrone), vincristine (Oncovin), vinblastine, prednisone (NOVP) chemotherapy on the potential for fertility of men with Hodgkin's disease (HD). Patients and Methods: Semen analyses were performed on 58 patients with stages I-III HD before, during, and after chemotherapy and after the sperm count recovered from the effects of abdominal radiotherapy that was given after chemotherapy. Results: Before the initiation of treatment, 84% of the patients were normospermic. Sperm counts declined significantly within 1 month after the start of NOVP chemotherapy. In the month after chemotherapy, 38% of patients were azoospermic, 52% had counts < 1 million/mL, and 10% had counts between 1 and 3 million/mL. Between 2.6 and 4.5 months after the completion of chemotherapy, sperm counts recovered rapidly to normospermic levels in 63% of patients. In the remaining patients who were followed up for at least 1 year after standard upper abdominal radiotherapy, counts also recovered to normospermic levels. Conclusion: NOVP chemotherapy, like most other regimens, produced marked temporary effects or spermatogenesis. However, sperm production recovered very rapidly, within 3 to 4 months after the end of NOVP chemotherapy. This pattern was caused by killing differentiating spermatogenic cells, but there was little cytotoxicity or inhibition of stem cells from mitoxantrone or the other drugs. After the combination of NOVP plus abdominal radiotherapy, sperm counts and motility were restored in most patients to pretreatment levels, which were compatible with normal fertility.

Original languageEnglish (US)
Pages (from-to)3488-3495
Number of pages8
JournalJournal of Clinical Oncology
Volume15
Issue number12
StatePublished - Dec 1997
Externally publishedYes

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Mitoxantrone
Vinblastine
Vincristine
Spermatogenesis
Prednisone
Hodgkin Disease
Drug Therapy
Sperm Count
Fertility
Radiotherapy
Semen Analysis
Sperm Motility
Spermatozoa
Stem Cells

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Meistrich, M. L., Wilson, G., Mathur, K., Fuller, L. M., Rodriguez, M. A., McLaughlin, P., ... Hagemeister, F. B. (1997). Rapid recovery of spermatogenesis after mitoxantrone, vincristine, vinblastine, and prednisone chemotherapy for Hodgkin's disease. Journal of Clinical Oncology, 15(12), 3488-3495.

Rapid recovery of spermatogenesis after mitoxantrone, vincristine, vinblastine, and prednisone chemotherapy for Hodgkin's disease. / Meistrich, Marvin L.; Wilson, Gene; Mathur, Kevin; Fuller, Lillian M.; Rodriguez, M. Alma; McLaughlin, Peter; Romaguera, Jorge E.; Cabanillas, Fernando F.; Ha, Chul S; Lipshultz, Larry I.; Hagemeister, Fredrick B.

In: Journal of Clinical Oncology, Vol. 15, No. 12, 12.1997, p. 3488-3495.

Research output: Contribution to journalArticle

Meistrich, ML, Wilson, G, Mathur, K, Fuller, LM, Rodriguez, MA, McLaughlin, P, Romaguera, JE, Cabanillas, FF, Ha, CS, Lipshultz, LI & Hagemeister, FB 1997, 'Rapid recovery of spermatogenesis after mitoxantrone, vincristine, vinblastine, and prednisone chemotherapy for Hodgkin's disease', Journal of Clinical Oncology, vol. 15, no. 12, pp. 3488-3495.
Meistrich ML, Wilson G, Mathur K, Fuller LM, Rodriguez MA, McLaughlin P et al. Rapid recovery of spermatogenesis after mitoxantrone, vincristine, vinblastine, and prednisone chemotherapy for Hodgkin's disease. Journal of Clinical Oncology. 1997 Dec;15(12):3488-3495.
Meistrich, Marvin L. ; Wilson, Gene ; Mathur, Kevin ; Fuller, Lillian M. ; Rodriguez, M. Alma ; McLaughlin, Peter ; Romaguera, Jorge E. ; Cabanillas, Fernando F. ; Ha, Chul S ; Lipshultz, Larry I. ; Hagemeister, Fredrick B. / Rapid recovery of spermatogenesis after mitoxantrone, vincristine, vinblastine, and prednisone chemotherapy for Hodgkin's disease. In: Journal of Clinical Oncology. 1997 ; Vol. 15, No. 12. pp. 3488-3495.
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title = "Rapid recovery of spermatogenesis after mitoxantrone, vincristine, vinblastine, and prednisone chemotherapy for Hodgkin's disease",
abstract = "Purpose: Because the effects of mitoxantrone on human male fertility were unknown, we determined prospectively the effects of three courses of mitoxantrone (Novantrone), vincristine (Oncovin), vinblastine, prednisone (NOVP) chemotherapy on the potential for fertility of men with Hodgkin's disease (HD). Patients and Methods: Semen analyses were performed on 58 patients with stages I-III HD before, during, and after chemotherapy and after the sperm count recovered from the effects of abdominal radiotherapy that was given after chemotherapy. Results: Before the initiation of treatment, 84{\%} of the patients were normospermic. Sperm counts declined significantly within 1 month after the start of NOVP chemotherapy. In the month after chemotherapy, 38{\%} of patients were azoospermic, 52{\%} had counts < 1 million/mL, and 10{\%} had counts between 1 and 3 million/mL. Between 2.6 and 4.5 months after the completion of chemotherapy, sperm counts recovered rapidly to normospermic levels in 63{\%} of patients. In the remaining patients who were followed up for at least 1 year after standard upper abdominal radiotherapy, counts also recovered to normospermic levels. Conclusion: NOVP chemotherapy, like most other regimens, produced marked temporary effects or spermatogenesis. However, sperm production recovered very rapidly, within 3 to 4 months after the end of NOVP chemotherapy. This pattern was caused by killing differentiating spermatogenic cells, but there was little cytotoxicity or inhibition of stem cells from mitoxantrone or the other drugs. After the combination of NOVP plus abdominal radiotherapy, sperm counts and motility were restored in most patients to pretreatment levels, which were compatible with normal fertility.",
author = "Meistrich, {Marvin L.} and Gene Wilson and Kevin Mathur and Fuller, {Lillian M.} and Rodriguez, {M. Alma} and Peter McLaughlin and Romaguera, {Jorge E.} and Cabanillas, {Fernando F.} and Ha, {Chul S} and Lipshultz, {Larry I.} and Hagemeister, {Fredrick B.}",
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T1 - Rapid recovery of spermatogenesis after mitoxantrone, vincristine, vinblastine, and prednisone chemotherapy for Hodgkin's disease

AU - Meistrich, Marvin L.

AU - Wilson, Gene

AU - Mathur, Kevin

AU - Fuller, Lillian M.

AU - Rodriguez, M. Alma

AU - McLaughlin, Peter

AU - Romaguera, Jorge E.

AU - Cabanillas, Fernando F.

AU - Ha, Chul S

AU - Lipshultz, Larry I.

AU - Hagemeister, Fredrick B.

PY - 1997/12

Y1 - 1997/12

N2 - Purpose: Because the effects of mitoxantrone on human male fertility were unknown, we determined prospectively the effects of three courses of mitoxantrone (Novantrone), vincristine (Oncovin), vinblastine, prednisone (NOVP) chemotherapy on the potential for fertility of men with Hodgkin's disease (HD). Patients and Methods: Semen analyses were performed on 58 patients with stages I-III HD before, during, and after chemotherapy and after the sperm count recovered from the effects of abdominal radiotherapy that was given after chemotherapy. Results: Before the initiation of treatment, 84% of the patients were normospermic. Sperm counts declined significantly within 1 month after the start of NOVP chemotherapy. In the month after chemotherapy, 38% of patients were azoospermic, 52% had counts < 1 million/mL, and 10% had counts between 1 and 3 million/mL. Between 2.6 and 4.5 months after the completion of chemotherapy, sperm counts recovered rapidly to normospermic levels in 63% of patients. In the remaining patients who were followed up for at least 1 year after standard upper abdominal radiotherapy, counts also recovered to normospermic levels. Conclusion: NOVP chemotherapy, like most other regimens, produced marked temporary effects or spermatogenesis. However, sperm production recovered very rapidly, within 3 to 4 months after the end of NOVP chemotherapy. This pattern was caused by killing differentiating spermatogenic cells, but there was little cytotoxicity or inhibition of stem cells from mitoxantrone or the other drugs. After the combination of NOVP plus abdominal radiotherapy, sperm counts and motility were restored in most patients to pretreatment levels, which were compatible with normal fertility.

AB - Purpose: Because the effects of mitoxantrone on human male fertility were unknown, we determined prospectively the effects of three courses of mitoxantrone (Novantrone), vincristine (Oncovin), vinblastine, prednisone (NOVP) chemotherapy on the potential for fertility of men with Hodgkin's disease (HD). Patients and Methods: Semen analyses were performed on 58 patients with stages I-III HD before, during, and after chemotherapy and after the sperm count recovered from the effects of abdominal radiotherapy that was given after chemotherapy. Results: Before the initiation of treatment, 84% of the patients were normospermic. Sperm counts declined significantly within 1 month after the start of NOVP chemotherapy. In the month after chemotherapy, 38% of patients were azoospermic, 52% had counts < 1 million/mL, and 10% had counts between 1 and 3 million/mL. Between 2.6 and 4.5 months after the completion of chemotherapy, sperm counts recovered rapidly to normospermic levels in 63% of patients. In the remaining patients who were followed up for at least 1 year after standard upper abdominal radiotherapy, counts also recovered to normospermic levels. Conclusion: NOVP chemotherapy, like most other regimens, produced marked temporary effects or spermatogenesis. However, sperm production recovered very rapidly, within 3 to 4 months after the end of NOVP chemotherapy. This pattern was caused by killing differentiating spermatogenic cells, but there was little cytotoxicity or inhibition of stem cells from mitoxantrone or the other drugs. After the combination of NOVP plus abdominal radiotherapy, sperm counts and motility were restored in most patients to pretreatment levels, which were compatible with normal fertility.

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