In a nutshell
This study examined whether imatinib (Gleevac) affects the fertility of men with chronic myeloid leukemia (CML). Researchers concluded that imatinib reduced sperm density, sperm count, sperm survival and activity when compared to healthy control participants.
CML has three phases: chronic, accelerated, and blast. Patients are generally diagnosed in the chronic phase. Long-term treatment with tyrosine kinase inhibitor therapy, such as imatinib, is standard for patients in the chronic phase.
CML can occur at any age and it is generally more common in men than in women. In Asia, the average age at diagnosis is as low as 38.3 years. Since many patients of reproductive are diagnosed with CML, more studies are needed to understand the impact of imatinib on reproduction and conception.
Methods & findings
The aim of this study was to examine the effect of imatinib therapy on male fertility.
48 men with CML in the chronic phase were included. All men were treated with imatinib. Average treatment duration was 36 months after diagnosis. Ultrasound exams as well as blood and sperm samples were used to record fertility. Results were compared to 50 healthy control participants from the general population and to 10 men with infertility.
Imatinib was able to cross from the blood into the testicles in CML patients. The levels of imatinib present in the semen were comparable to the imatinib levels in the blood. Sperm density, sperm count, sperm survival rate and activity were all significantly lower in imatinib-treated patients compared to healthy control participants. However, these numbers were higher than those of infertile men.
The shape and size of the testicles and epididymis (a curved structure at the back of the testicle) were not affected by imatinib treatment. 39.6% of CML patients presented with a hydrocele testicle. This is when fluid accumulates in the area covering the testicle, which is generally painless and has no known effect on fertility. Sex hormone levels were within normal ranges in all groups studied.
The bottom line
This study found that sperm density, sperm count, sperm survival and activity were reduced in imatinib-treated patients. Imatinib did not affect the structure of reproductive organs or sex hormone levels.
The fine print
Larger studies that include CML patients not receiving any treatment are needed to confirm these results.
Published By :
Aug 08, 2017