Testicular infiltrates in children with acute lymphoblastic leukemia: A prospective study

Juan J. Ortega, G. Javier, Nuria Torán

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25 Citations (Scopus)


The incidence of testicular infiltrates in 68 boys with acute lymphoblastic leukemia in first remission (1974‐81), was prospectively investigated through careful clinical examination and routine bilateral biopsies at 2‐3 years of remission. All boys were under 14 years of age and they were treated with protocols D.74 and Pethema 7/78. Seven patients (10.3%) presented an isolated testicular relapse (ITR) during the chemotherapy period. In 13 of the 43 testicular biopsies (31%) leukemic infiltrates were found, and in another two findings were controversial. Three boys, two with previous negative biopsies, had an ITR 6 to 18 months after therapy was stopped. Finally, three others had simultaneous relapses in testes and bone marrow, one during chemotherapy and two after suppression. In all, 23 patients (33.8%) in first remission had overt or occult ITR. Overall estimated incidence rate of testes leukemia is 40% in all the groups. Incidence of early and occult ITR was higher in boys with initial WBC counts over 20 × 109/1. Therapy in ITR generally consisted of local radiotherapy (20‐25 Gy), a new induction treatment followed by 2‐year maintenance treatment; in three patients with early ITR, orchidectomy was also performed and six were given a new CNS preventive treatment. Clinical course in the seven patients with early ITR was unfavourable in five, with subsequent hematological relapses and death; one had a long‐term disease‐free survival (80 + months) and the other was a recent case. Ten of the 13 patients with occult infiltrates continued in remission and four were off treatment with a follow‐up of over 66 months. The three patients with late ITR were in 2nd remission at 8‐18 months after a new cessation of therapy. It may be concluded from this study that prognosis in ITR is related to the phase of presentation: it is unfavourable in cases of early ITR, but in occult infiltrates, detected by routine biopsy, and in late ITR combined therapy is effective in most cases. Copyright © 1984 Wiley‐Liss, Inc., A Wiley Company
Original languageEnglish
Pages (from-to)386-393
JournalMedical and Pediatric Oncology
Issue number6
Publication statusPublished - 1 Jan 1984


  • tested biopsy
  • testes leukemia
  • testicular infiltrates
  • testicular infiltrates in ALL


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