An increasingly important aspect of cancer treatment in children is how cancer treatment today affects the child's ability to reproduce as an adult. When boys who've reached sexual maturity are diagnosed with certain forms of cancer, their sperm can be frozen for future use. Younger boys, however, don't yet produce sperm so it's not so easy to preserve fertility when cancer is diagnosed before puberty. A new breakthrough, however, could lead to the cultivation of testicular tissue taken from even the youngest boys.

One of the most common forms of childhood cancer is acute lymphoblastic leukemia (ALL). Previous studies found cancer cells in the testicular tissue of as many as 30% of boys with ALL.

Cancer treatment options vary according to the type and location of the disease and not all treatments impair fertility. Treatment for leukemias, however, do endanger fertility as do bone and brain cancers and Hodgkin's disease.

Regardless of type or location, almost 80% of all children diagnosed with cancer now survive well into adulthood. Many of them want children of their own someday, inspiring medical scientists to find ways to harvest reproductive tissue before cancer treatments destroy it.

Hooman Sadri-Ardekani, MD, Ph.D., is the lead author in the study which took place at the Avicenna Research Institute in Tehran, Iran, and at the University of Amsterdam, Netherlands. Sadri-Ardekani now instructs classes on urology and regenerative medicine at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina.

Sadri-Ardekani says his study addressed an important issue of safety — cultivating healthy testicular tissue without preserving cancer cells, too. He used bone marrow and testicular tissue from three young ALL patients to test his theory.

Sadri-Ardekani's research team cultivated the bone marrow cells under different scenarios. One culture involved isolated cancer cells only. Other cultures involved a mix of cancer and healthy testicular cells in varying ratios. The most cancer-dense culture was 40% cancer cells, 60% testicular tissue.

While testicular cells thrived and reproduced during cultivation, the ALL cells died. Within 14 days, all the ALL cells in the cancer-only culture died. In the mixed cultures, all ALL cells died within 26 days. The healthy, cancer-free testicular cells multiplied by a factor of 18,000%, producing enough tissue to freeze and preserve for future use.

"Based on these findings," said Sadri-Ardekani, "we recommend that all boys with cancer be offered the option of storing testicular tissue for possible future clinical use."

Source: Sadri-Ardekani, Hooman, MD, Ph.D., et al. "Eliminating acute lymphoblastic leukemia cells from human testicular cell cultures: a pilot study." Fertility and Sterility. Elsevier Inc. Feb 26, 2014. Web. Apr 10, 2014.