Xiaohui Chang1, Lin Zhou2, Xiaoxia Chen3, Baoli Xu4, Yubin Cheng1, Shujun Sun1, Meiyun Fang5, Yang Xiang6. 1. Department of Hematology, The 210th Hospital of Chinese People's Liberation Army, Liaoning, China. 2. Department of Scientific Research, The 210th Hospital of Chinese People's Liberation Army, Liaoning, China. 3. Department of Pharmacy, The Liaoning University of Traditional Chinese Medicine, Liaoning, China. 4. Department of Pharmacy, The 210th Hospital of Chinese People's Liberation Army, Liaoning, China. 5. Department of Hematology, The First Affiliated Hospital, Dalian Medical University, Liaoning, China. fangmeiyun@medmail.com.cn. 6. Department of Hematology, The 210th Hospital of Chinese People's Liberation Army, Liaoning, China. 66463875@qq.com.
Abstract
BACKGROUND: Imatinib is a first-line tyrosine kinase inhibitor for treating chronic myelogenous leukaemia (CML) and has greatly improved the prognosis of this disease. An increasing number of CML patients of reproductive age are diagnosed each year, and the impact of imatinib on fertility is a major concern. Providing useful advice to these patients regarding the choice of their therapeutic treatment is very important. OBJECTIVE: This study examined the impact of imatinib on the fertility of male patients with CML in the chronic phase. PATIENTS AND METHODS: We performed a study of 48 adult male CML patients in the chronic phase (CML-CP), 50 healthy control subjects, and 10 male patients with infertility. Imatinib levels in semen and plasma were measured using high-performance liquid chromatography/mass spectrometry. We examined the effects of imatinib on sperm parameters and the male reproductive system using a computer-assisted sperm assay and ultrasound, respectively. We analysed sex hormone levels in the sera of CML-CP patients using an enzyme-linked immunosorbent assay. RESULTS: Imatinib levels in semen were comparable to plasma levels in CML-CP patients. CML-CP patients treated with imatinib exhibited reduced sperm density, counts, survival rates, and activity. Ultrasound demonstrated that the shape and size of the testis and epididymis in CML-CP patients undergoing imatinib treatment were normal. However, 19 of these patients exhibited a hydrocele in their tunica vaginalis, with a large dark area of effusion (0.7-2.9 cm in width). Sex hormone levels in the sera of the CML-CP patients were normal. CONCLUSIONS: These results suggest that imatinib crosses the blood-testis barrier and reduces sperm density, sperm count, survival rates, and activity in CML-CP patients. However, imatinib did not affect the structure of reproductive organs or sex hormone levels.
BACKGROUND:Imatinib is a first-line tyrosine kinase inhibitor for treating chronic myelogenous leukaemia (CML) and has greatly improved the prognosis of this disease. An increasing number of CMLpatients of reproductive age are diagnosed each year, and the impact of imatinib on fertility is a major concern. Providing useful advice to these patients regarding the choice of their therapeutic treatment is very important. OBJECTIVE: This study examined the impact of imatinib on the fertility of male patients with CML in the chronic phase. PATIENTS AND METHODS: We performed a study of 48 adult male CMLpatients in the chronic phase (CML-CP), 50 healthy control subjects, and 10 male patients with infertility. Imatinib levels in semen and plasma were measured using high-performance liquid chromatography/mass spectrometry. We examined the effects of imatinib on sperm parameters and the male reproductive system using a computer-assisted sperm assay and ultrasound, respectively. We analysed sex hormone levels in the sera of CML-CPpatients using an enzyme-linked immunosorbent assay. RESULTS:Imatinib levels in semen were comparable to plasma levels in CML-CPpatients. CML-CPpatients treated with imatinib exhibited reduced sperm density, counts, survival rates, and activity. Ultrasound demonstrated that the shape and size of the testis and epididymis in CML-CPpatients undergoing imatinib treatment were normal. However, 19 of these patients exhibited a hydrocele in their tunica vaginalis, with a large dark area of effusion (0.7-2.9 cm in width). Sex hormone levels in the sera of the CML-CPpatients were normal. CONCLUSIONS: These results suggest that imatinib crosses the blood-testis barrier and reduces sperm density, sperm count, survival rates, and activity in CML-CPpatients. However, imatinib did not affect the structure of reproductive organs or sex hormone levels.
Authors: J L Steegmann; M Baccarani; M Breccia; L F Casado; V García-Gutiérrez; A Hochhaus; D-W Kim; T D Kim; H J Khoury; P Le Coutre; J Mayer; D Milojkovic; K Porkka; D Rea; G Rosti; S Saussele; R Hehlmann; R E Clark Journal: Leukemia Date: 2016-04-28 Impact factor: 11.528