Wake Forest Baptist Medical Center is one of
a few centers in the world – and the only one in North Carolina – offering
young boys with cancer the opportunity to participate in a research study
focused on fertility preservation and restoration.
The research,
conducted by the Medical Center’s Wake Forest Institute for Regenerative
Medicine (WFIRM) under the direction of Anthony Atala, M.D., institute
director, gives boys who have a high risk of becoming sterile the option to
“bank” a small piece of testicular tissue prior to treatment.
“The average
survival rates for childhood cancer are around 80 percent, but a side effect of
some treatments can be permanent sterility,” said Thomas W. McLean, M.D., a
pediatric cancer specialist, who co-leads the experimental biological bank with
Hooman Sadri-Ardekani, M.D., Ph.D., a male infertility specialist at WFIRM.
“Preserving or restoring the ability of our patients to one day have children
is an important aspect of their treatment.”
From the
stored tissue, researchers can extract spermatogonial stem cells (SSCs), which
are responsible for the continuous production of sperm throughout adult life.
Physicians and
scientists hope that when the boys reach adulthood, the cells can be
transplanted back into their testicles through a simple injection and they will
be able to produce sperm.
“SSC transplantation has not yet been attempted in humans, but has been
performed successfully in several species of animals, including monkeys,” said
Sadri-Ardekani, who developed
the first laboratory protocol to isolate and grow
human SSCs from small testicular biopsies.
McLean said a treatment to preserve fertility in boys who are not
sexually mature is especially needed because no options currently exist for
them. Older boys and men, on the other hand, can bank sperm for future use and
women and girls can bank eggs or ovarian tissue.
SSCs are particularly sensitive to radiation and chemotherapy. Examples
of cancers that involve these treatments that have a high risk of infertility
are certain leukemias, Hodgkin’s disease, brain tumors and bone cancer.
For the current research study, participants have a small piece of
testicular tissue harvested under general anesthesia while they are undergoing
another procedure associated with their care, such as putting a catheter in the
chest to deliver chemotherapy drugs.
“Because the testicular biopsies do not contain enough SSCs to fully
repopulate the testis, we developed a protocol to multiply the original SSCs by
sufficient numbers for re-implantation,” said Sadri-Ardekani.
The experimental testicular tissue banking was designed under Good
Tissue Processing (GTP) practices and is registered by the U.S. Food and Drug
Administration and the ICCBBA, an international standards organization, for possible
future cell therapy. The tissue is frozen free of charge until patients are at
least 18 years old. At that time, it is expected that they will have the
opportunity to enter into a separate research study to consider implantation.
“We are pleased that Wake Forest Baptist can offer this option to our
young patients at Brenner Children’s Hospital,” said McLean. “Our hope is that
by the time they are adults, these stored cells can be used to restore their
fertility.”
This project is a collaborative effort of Blood and Marrow
Transplantation, the Center for Reproductive Medicine, Pediatric Oncology,
Pediatric Urology, Pediatric Surgery and WFIRM.
Media Relations
Karen Richardson: krchrdsn@wakehealth.edu, 336-716-4453