title: Dynamics of fertility impairment and recovery after allogeneic haematopoietic stem cell transplantation in childhood and adolescence: results from a longitudinal study.
abstract: OBJECTIVE
  Fertility impairment and recovery after haematopoietic stem cell transplantation (HSCT) have been reported in both sexes, but little is known about how they develop over time. Our aim was to describe the dynamics of fertility impairment and recovery after HSCT.
  
  
  METHODS
  We retrieved treatment and fertility data for up to 12 years of 361 paediatric patients with malignant and non-malignant diseases from seven European centres. The patients had been treated with allogeneic HSCT between 2000 and 2005.
  
  
  RESULTS
  Development of fertility impairment was observed in males (123/217, 56%) after a median time of 2.6 years (range 0.1-11.4) and in females (82/144, 57%) after 2.3 years (range 0.1-12.0) after HSCT. Different busulfan dosages had only a slight impact on the onset of fertility impairment (busulfan ≥ 16 mg/kg with a median time to fertility impairment of 2.9 vs. 3.9 years after busulfan <14 mg/kg). Recovery from fertility impairment was observed in 17 participants after a median time of 4.1 years (range 1-10.6) in females (10/144, 7%) and 2.0 years (range 1-6.3) in males (7/217, 3 %) after fertility impairment first appeared.
  
  
  CONCLUSIONS
  In the light of the dynamics of fertility impairment and recovery in the HSCT patients reviewed, these patients should be counselled comprehensively regarding fertility preservation measures.
authors.affiliation: Department of Paediatric Oncology/Haematology/Stem cell transplantation, Charité-Universitätsmedizin Berlin, Campus Virchow-Klinikum, Augustenburger Platz 1, Mittelallee 6a, 13353, Berlin, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Pfitzer
authors.forename: H
authors.initials: H
authors.lastname: Orawa
authors.forename: M
authors.initials: M
authors.lastname: Balcerek
authors.forename: T
authors.initials: T
authors.lastname: Langer
authors.forename: U
authors.initials: U
authors.lastname: Dirksen
authors.forename: P
authors.initials: P
authors.lastname: Keslova
authors.forename: N
authors.initials: N
authors.lastname: Zubarovskaya
authors.forename: F R
authors.initials: FR
authors.lastname: Schuster
authors.forename: A
authors.initials: A
authors.lastname: Jarisch
authors.forename: G
authors.initials: G
authors.lastname: Strauss
authors.forename: A
authors.initials: A
authors.lastname: Borgmann-Staudt
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000150:complications* / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007246:Infertility / Q000209:etiology* / Q000517:prevention & control*; D008137:Longitudinal Studies; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D055815:Young Adult
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