SEMEN CRYOPRESERVATION AND POSTTHERAPEUTI C GONADAL DYSFUNCTION IN NON-HODGKINS DISEASE - EXPERIENCE AT THE INSTITUT GUSTAVE-ROUSSY FROM 1989 TO 1993

More than 50% of patients with non Hodgkin's lymphomas (NHL) are long- term survivors. We have retrospectively analysed the indication of sem en cryopreservation and late gonadal toxicity for 213 males patients c onsecutively treated at the Gustave Roussy institute from 1980 to 1993 for NHL. The mean age was 30 years (15-42) and all patients received chemotherapy with or without radiotherapy. Initial spermograms and cry opreservation of semen were obtained in only 24 patients (half of them between 1991 and 1993). Spermogram characteristics were as follows: 1 1 normal; 13 abnormal with oligospermia (n = 7), asthenospermia (n = 7 ), and teratospermia (n = 8). No relation was found between the prethe rapeutic status and the semen sample quality. Cryopreservation was pos sible in only 22 cases, and among the 16 surviving patients, two have undergone insemination and the remaining 14 are maintaining their cryo preserved semen samples. Long-term gonadal toxicity was assessed on sp ermograms of nine patients: three of whom had evidence of return to pr etherapeutic status. FSH levels were assayed for 48 patients: at a thr eshold of 8 g/m(2) of cyclophosphamide, 86% of patients had elevated v alues (P < 10(-6)). Cumulated doxorubicin doses were nor correlated wi th FSH elevation Five patients have had children after treatment In co nclusion, chemotherapy for NHL seems to induce an intermediate level o f gonadal toxicity which is between that of MOPP and ABVD. Complete in formation about gonadal toxicity of chemotherapy is warranted for youn g male patients who are to receive chemotherapy and semen cryopreserva tion should be suggested to this population.