Evaluating testicular tissue for future autotransplantation: focus on cancer cell contamination and presence of spermatogonia in tissue cryobanked for boys diagnosed with a hematological malignancy.

This article investigates the contamination rate by cancer cells and spermatogonia counts in immature testicular tissue (ITT) harvested from pre- and peri-pubertal boys diagnosed with hematological malignancies—specifically acute lymphoblastic leukemia (ALL) and lymphomas—prior to any gonadotoxic therapy. Using histology, immunohistochemistry (IHC), and polymerase chain reaction (PCR) on formalin-fixed paraffin-embedded (FFPE) tissue samples from 28 patients, cancer cell contamination was detected in 39% of cases, with a significantly higher rate in ALL patients (57%) compared to lymphoma patients (14%). While histology alone did not reveal malignant cells, IHC and PCR demonstrated greater sensitivity, underscoring the risk of cancer cell reseeding if autotransplantation of cryopreserved ITT is performed. Additionally, spermatogonia numbers appeared reduced compared to healthy reference cohorts, though standardized Z-score analysis did not confirm a significant decrease, indicating the need for further research on the disease's impact on fertility potential. The findings highlight the clinical challenge of balancing fertility preservation with oncological safety in this population.