Similar results have been demonstrated in men treated with cisplatin-based chemotherapy for osteosarcoma (2,33) and lung cancer (34). However, the majority of patients treated with cytotoxic chemotherapy for leukemia do not have persistent gonadal dysfunction. Wallace et al. (35) found long-term germinal epithelial dysfunction in only 6 out of 36 (17%) patients treated during childhood for acute lympho-cytic leukemia, although the follow-up period in this study was considerable, and the majority of patients had evidence of germinal epithelial damage on testicular biopsy immediately after chemotherapy (which included cyclophosphamide and cytosine arabinoside), a median time of 10.7 yr earlier.
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