title: Impaired testicular function after an ifosfamide-containing regimen for pediatric osteosarcoma: a case series and review of the literature.
abstract: To assess testicular function after standard dose ifosfamide, we evaluated 6 young adult osteosarcoma survivors (median age at diagnosis, 16.5 y; median follow-up, 4 y) treated with ifosfamide (median dose, 45.5 g/m) as part of a chemotherapy regimen (adriamycin/cisplatin/methotrexate/ifosfamide/± muramyl-tripeptide-phosphatidyl-ethanolamine). Four of 6 survivors (67%) had abnormal semen analysis (2 oligospermic, 2 azoospermic). Of those, 1/4 had reduced testicular volume, and 2/3 elevated FSH levels. All reported adequate sexual function, 6/6 had normal testosterone levels, but 4/6 had elevated LH levels. Ifosfamide exposure in the context of this regimen was associated with a high likelihood of impaired spermatogenesis and Leydig cell insufficiency.
authors.affiliation: *Department of Pediatrics, Dana-Farber Cancer Institute/Boston Children's Hospital †Department of Pediatric Hematology/Oncology, Massachusetts General Hospital, Boston, MA ‡Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Kenney
authors.forename: Eileen
authors.initials: E
authors.lastname: Duffey-Lind
authors.forename: David
authors.initials: D
authors.lastname: Ebb
authors.forename: Charles A
authors.initials: CA
authors.lastname: Sklar
authors.forename: Holcombe
authors.initials: H
authors.lastname: Grier
authors.forename: Lisa
authors.initials: L
authors.lastname: Diller
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D002945:Cisplatin / Q000008:administration & dosage; D015331:Cohort Studies; D058490:Disorder of Sex Development, 46,XY / Q000139:chemically induced*; D004317:Doxorubicin / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007986:Luteinizing Hormone / Q000378:metabolism; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D012516:Osteosarcoma / Q000188:drug therapy* / Q000378:metabolism; D011379:Prognosis; D012196:Review Literature as Topic; D013091:Spermatogenesis / Q000187:drug effects*; D013737:Testis / Q000002:abnormalities*; D013739:Testosterone / Q000378:metabolism; D055815:Young Adult
chemical_list: D013739:Testosterone; D004317:Doxorubicin; D007986:Luteinizing Hormone; D002945:Cisplatin; D007069:Ifosfamide; D008727:Methotrexate