Background: diagnostic tools make it difficult to separate


lymphoblastic leukaemia (ALL) is a malignant disorder of lymphoid progenitor
cells and the most common cancer type in children. Over the last decades, treatment
for ALL has improved substantially. Continuous effort on developing
risk-stratified multi-agent chemotherapy through cooperative trials worldwide, has
led to an increase in the survival rate of childhood ALL from less than 10% in
the 1960’s to approximately 90% nowadays (1). Due to this substantial increase
in survival rate, long-term complications of therapy, including infertility,
take on greater significance for the survivors and their families (2). 

reviews have been published about the fertility status following childhood
malignancy treatment. In general, these studies included very heterogeneous study
populations consisting of patients with different cancer diagnoses. Also treatment
procedures differed substantially between patients. Besides this a diverse
range of diagnostic tools was used to assess fertility. The heterogeneous study
population and the variety of diagnostic tools make it difficult to separate
the effects of specific diagnoses and treatments on fertility (3), (4).

For this
reason, it would be useful to investigate the effects of childhood malignancy
treatment on fertility in a more homogenous study population, including ALL
patients only. This thesis aims to describe the effects of childhood ALL
treatment on fertility in both male and female survivors of ALL, by providing
an overview of the studies that have been performed on this topic.

Research question: What is the effect of childhood ALL treatment
on fertility in both male and female survivors of ALL?


To find the
answer to this research question the databases Pubmed and Google Scholar will
be searched for articles that have been published on this topic. The following
inclusion criteria will be used to make a selection of articles: ALL diagnosis
before the age of 18, survived ?2 years since diagnosis (in continuous
remission without further treatment), articles describing effects of treatment
on fertility (analysis based on serum hormone levels, sperm quality, physical
examination or interviews), articles published in English. Exclusion criteria:
studies which included patients diagnosed with a childhood malignancy other
than ALL, maximum age at the time of the study: 40 years. Key words: acute lymphoblastic
leukemia/acute lymphocytic leukemia, fertility, childhood/pediatrics. In this review
a summary of the results of previous performed studies will be given and taking
into account the reliability of the different articles, the final conclusion
will be formulated.

following search terms will be used to find articles in the Pubmed database:

OR childhood OR pediatric*) AND (“Precursor Cell Lymphoblastic
Leukemia-Lymphoma”Mesh OR acute lymphocytic leukemia OR acute
lymphoblastic leukemia OR ALL OR acute lymphocytic leukaemia OR acute
lymphoblastic leukaemia) AND (“Fertility”Mesh OR sexual function OR
gonadal function OR sperm concentration OR testicular morphological changes OR
semen quality OR ovarian function OR sperm quality OR sperm concentration OR
sperm analysis OR fecundity)

Date: 07-01-2018

Number of hits: 126

Number of selected articles: 11