Early vs. late treatment with darbepoetin alfa in patients with genitourinary tumors during chemotherapy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18583-18583
Author(s):  
K. Elandt ◽  
P. Horak ◽  
K. C. Schieder ◽  
R. Leikermoser ◽  
R. Altmann ◽  
...  
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Early Treatment ◽  
Darbepoetin Alfa ◽  
Red Blood Cell Transfusion ◽  
Rank Test ◽  
Late Treatment ◽  
Group A ◽  
The Mean ◽  
Group B

18583 Background: Anemia is a common complication in patients who receive anticancer therapy. We evaluated the efficacy of darbepoetin alfa in early vs. late treatment in patients with genitourinary tumors undergoing chemotherapy. We wanted to investigate whether an early onset of treatment with darbepoetin alfa reduces frequency of red blood cell transfusion and increases patients’ QoL. Methods: Patients on chemotherapeutic treatment for a urogenital neoplasia and a hemoglobin between 10–12 g/dl were randomized between an immediate start of treatment with darbepoetin alfa 150 μg sc weekly (group A) and a Hb below 10 g/dl or clinical symptoms (group B). Results: 52 patients out of 68 (76.5%) completed the trial, 7/40 patients (17%) in group A and 9/28 patients (32%) in group B withdraw from the study. An intent to treat analysis was performed and showed a significant superiority (p = 0.023, log-rank test) for the early treatment. In group A, only 12.5% of patients (5/40) received at least one red blood cell transfusion compared to group B, where 39% of the patients (11/28) received a transfusion. In group A the mean Hb level increased steadily, starting with a baseline value of 11.0 g/dl. In week 21 a mean Hb level of 12.8 g/dl was reached, resulting in an overall increase in Hb of 1.8 g/dl. In group B, which had a comparable baseline Hb level of 10.9 g/dl, the mean Hb value decreased initially during the first 4 weeks to 10.0 g/dl. In week 21 a level of 11.4 g/dl was reached, resulting in a total Hb-increase of 0.5 g/dl. When anemia treatment was initiated early, the mean Hb level always remained in the range of 11 to 13 g/dl from the beginning of the study, in the B group the mean level of 11 g/dl was first achieved after 12 weeks. 35% in group A compared to 54% in group B (p = 0.13) experienced a dose doubling. The mean values (EORTC-QLQ-C30) of all symptom scales in group A were markedly below those in group B with the highest difference for dyspnea, 29.1 points (p < 0.001). Conclusions: Early treatment with darbepoetin alfa in patients with urogenital cancer results in optimal hemoglobin levels according to EORTC guidelines and consequently in a reduction of red blood cells transfusion. Furthermore, in patients with earlier initiation of treatment a clinically significant improvement of dyspnea can be observed. [Table: see text]

scholarly journals Safety and Cost Effectiveness of a 10 × 109/L Trigger for Prophylactic Platelet Transfusions Compared With the Traditional 20 × 109/L Trigger: A Prospective Comparative Trial in 105 Patients With Acute Myeloid Leukemia

Blood ◽  
1998 ◽  
Vol 91 (10) ◽  
pp. 3601-3606 ◽  
Author(s):  
Hannes Wandt ◽  
Markus Frank ◽  
Gerhard Ehninger ◽  
Christiane Schneider ◽  
Norbert Brack ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Myeloid Leukemia ◽  
Platelet Transfusion ◽  
Bleeding Complications ◽  
Group A ◽  
Red Blood Cell Transfusions ◽  
Group B ◽  
Acute Myeloid

Abstract In 105 consecutive patients with de novo acute myeloid leukemia (French-American-British M3 excluded), we compared prospectively the risk of bleeding complications, the number of platelet and red blood cell transfusions administered, and the costs of transfusions using two different prophylactic platelet transfusion protocols. Two hundred sixteen cycles of induction or consolidation chemotherapy and 3,843 days of thrombocytopenia less than 25 × 109/L were evaluated. At the start of the study, each of the 17 participating centers decided whether they would use a 10 × 109/L prophylactic platelet transfusion trigger (group A/8 centers) or a 20 × 109/L trigger (group B/9 centers). Bleeding complications (World Health Organization grade 2-4) during treatment cycles were comparable in the two groups: 20 of 110 (18%) in group A and 18 of 106 (17%) in group B (P = .8). Serious bleeding events (grade 3-4) were generally not related to the patient's platelet count but were the consequence of local lesions and plasma coagulation factor deficiencies due to sepsis. Eighty-six percent of the serious bleeding episodes occurred during induction chemotherapy. No patient died of a bleeding complication. There were no significant differences in the number of red blood cell transfusions administered between the two groups, but there were significant differences in the number of platelet transfusions administered per treatment cycle: pooled random donor platelet concentrates averaged 15.4 versus 25.4 (P < .01) and apheresis platelets averaged 3.0 versus 4.8 (P < .05) for group A versus group B, respectively. This resulted in the cost of platelet therapy being one third lower in group A compared with group B without any associated increase in bleeding risk.

A Comparison of Administration Time between Red Blood Cell Transfusion and Chemotherapy.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4186-4186
Author(s):  
Ian H. Chin-Yee ◽  
Anargyros Xenocostas ◽  
Wendy W. Cheung ◽  
Anita S. Hibbert
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Tertiary Care ◽  
Central Line ◽  
High Rate ◽  
Red Blood Cell Transfusion ◽  
Nursing Time ◽  
Hematological Disorders ◽  
Outpatient Chemotherapy ◽  
The Mean

Abstract In oncology patients, the majority of chemotherapy and red blood cell (RBC) transfusions occur in outpatient ‘chemotherapy’ units, where they compete for resources such as nursing time and “chair-time”. This study was to accurately assess the “chair-time” consumed by transfusion patients, in order to estimate the chemotherapy administration opportunities lost to RBC transfusions. Over four weeks, “chair-time”, defined as the time difference between the admission of each patient into care to their time of discharge, was prospectively evaluated in a tertiary-care outpatient cancer clinic with a referral population base of 2 million. Chair-times were then grouped into three types of care - RBC transfusions, chemotherapy administrations, and “other” (phlebotomy, central line catheter care, etc.) - to enable comparison. Chair-time is reported as a mean (+/− SD). Patient demographics (age, sex, diagnosis, chemotherapy regimen, pre-transfusion hemoglobin) were also recorded. A total of 1354 visits to the chemotherapy suite were captured over one month. Of these, 1279 visits had evaluable data for further analysis, and can be divided as follows: 1023 (80%) chemotherapy administrations, 44 (3.4%) RBC transfusions, and 212 (16.6%) “other”. 38 patients accounted for the 44 RBC transfusions. Of those, 14 were hematological malignancy patients (ALL, AML, CLL, HD, Myeloma, Lymphoma), 12 were solid tumor patients and the remaining 12 had other hematological disorders (Aplastic Anaemia, Myelodysplasia, Myelofibrosis). Among the malignant patients, 20 were receiving chemotherapy during the study period. The mean chair-time for all accurately recorded events was 1 hr 49 min (+/− 1 hr 39 min). Divided into types of care, the mean chair times were: 1 hr 59 min (+/− 1 hr 40 min) for chemotherapy, 3 hr 51 min (+/− 47 min) for RBC transfusion, and 34 min (+/− 43 min) for “other” care. The average time per RBC unit transfused was 1 hr 49 min (+/− 19 min) and the average number of units per transfusion was 2.2 units. When chemotherapy chair-times were examined, and patients were grouped by diagnoses, it was found that patients with lymphoma (most commonly treated with R-CHOP, or other Rituximab containing regimens), and gynecological cancers (most commonly treated with regimens containing carboplatin) had the longest chair-times, at 4 hr 20 min (+/− 1 hr 24 min) and 3 hr 50 min (+/− 2 hr 11 min) respectively. Although RBC transfusions make up only 3.4% of all events in our chemotherapy suite, they occupy almost twice as much chair-time as compared to chemotherapy. Depending on the patient population, clinics with a high rate of RBC transfusions might consider transfusion alternatives, as emerging monoclonal antibody chemotherapies augment the time necessary for administering chemotherapy, and chair-time becomes an increasingly valuable resource.

scholarly journals Safety and Cost Effectiveness of a 10 × 109/L Trigger for Prophylactic Platelet Transfusions Compared With the Traditional 20 × 109/L Trigger: A Prospective Comparative Trial in 105 Patients With Acute Myeloid Leukemia

Blood ◽  
1998 ◽  
Vol 91 (10) ◽  
pp. 3601-3606 ◽  
Author(s):  
Hannes Wandt ◽  
Markus Frank ◽  
Gerhard Ehninger ◽  
Christiane Schneider ◽  
Norbert Brack ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Myeloid Leukemia ◽  
Platelet Transfusion ◽  
Bleeding Complications ◽  
Group A ◽  
Red Blood Cell Transfusions ◽  
Group B ◽  
Acute Myeloid

In 105 consecutive patients with de novo acute myeloid leukemia (French-American-British M3 excluded), we compared prospectively the risk of bleeding complications, the number of platelet and red blood cell transfusions administered, and the costs of transfusions using two different prophylactic platelet transfusion protocols. Two hundred sixteen cycles of induction or consolidation chemotherapy and 3,843 days of thrombocytopenia less than 25 × 109/L were evaluated. At the start of the study, each of the 17 participating centers decided whether they would use a 10 × 109/L prophylactic platelet transfusion trigger (group A/8 centers) or a 20 × 109/L trigger (group B/9 centers). Bleeding complications (World Health Organization grade 2-4) during treatment cycles were comparable in the two groups: 20 of 110 (18%) in group A and 18 of 106 (17%) in group B (P = .8). Serious bleeding events (grade 3-4) were generally not related to the patient's platelet count but were the consequence of local lesions and plasma coagulation factor deficiencies due to sepsis. Eighty-six percent of the serious bleeding episodes occurred during induction chemotherapy. No patient died of a bleeding complication. There were no significant differences in the number of red blood cell transfusions administered between the two groups, but there were significant differences in the number of platelet transfusions administered per treatment cycle: pooled random donor platelet concentrates averaged 15.4 versus 25.4 (P < .01) and apheresis platelets averaged 3.0 versus 4.8 (P < .05) for group A versus group B, respectively. This resulted in the cost of platelet therapy being one third lower in group A compared with group B without any associated increase in bleeding risk.

scholarly journals An in vivo assessment of the use of Haematopan B12 in the treatment of experimentally induced anaemia in domestic rabbits.

2021 ◽  
Vol 32 (2) ◽  
pp. 301-307
Author(s):  
A. A. Adedapo ◽  
A. B. Saba ◽  
O.A. Dina
Keyword(s):  
Blood Cell ◽  
Red Blood Cell ◽  
Study Group ◽  
Group A ◽  
Domestic Rabbits ◽  
Group B ◽  
Hb Concentration ◽  
In Vivo Assessment ◽  
Rbc Count

A total of 15 domestic rabbits divided into 3 groups of 5 animals per group were used in this study Group A animals (control) were not bled but those in groups B and C were bled to induce anaemia. Group B were left to recover by normal haemopoiesis while those in group C were treated with Hematopan B12*, a commercially prepared haematinic. The post-bleeding treatment haematologic values were obtained at given intervals (7 days) and compared with the pre-bleeding values earlier obtained. The result of this study showed that the group B animals recovered gradually by physiologic haemopoeisis while animals in group C showed accelerated recovery since these animals had a better and faster response in terms of white blood cell (WBC), red blood cell (RBC) count and haemoglobin (Hb) concentration. Thus Haematopan B12 is an effective haematinic. 

Comparison of red blood cell transfusion rates of epoetin alfa and darbepoetin alfa in an inpatient oncology setting

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 16002-16002
Author(s):  
F. Vekeman ◽  
R. S. McKenzie ◽  
S. Watson ◽  
S. Mody ◽  
P. Lefebvre ◽  
...  
Keyword(s):  
Blood Cell ◽  
Cancer Patients ◽  
Red Blood Cell ◽  
Darbepoetin Alfa ◽  
Relative Effectiveness ◽  
Red Blood Cell Transfusion ◽  
Inpatient Setting ◽  
Epoetin Alfa ◽  
Transfusion Requirements ◽  
Rbc Transfusion

16002 Background: Epoetin alfa (EPO) and darbepoetin alfa (DARB) are used to treat cancer-related anemia and to reduce the requirements for blood transfusions. To date, limited information on the relative effectiveness of these agents in the inpatient setting is available. This analysis evaluated red blood cell (RBC) transfusion rates in cancer patients receiving EPO or DARB during hospitalization. Methods: An analysis of electronic inpatient hospital records from the Premier Perspective Comparative Hospital Database was conducted to compare RBC transfusion rates in cancer patients receiving EPO or DARB therapy. Study subjects were identified through hospitalizations recorded between 07/2002 and 03/2005 from over 500 hospitals nationwide. Patients were required to be ≥18 years old, have a primary admitting diagnosis of cancer and be treated with EPO or DARB during hospitalization. Patients who had received renal dialysis were excluded. To minimize effects of outliers, 5% of patients with extreme doses in each group were excluded from the dosing analysis. In addition to descriptive statistics on transfusion requirements, a multivariate logistic model was employed to isolate the effect of an individual erythropoietic agent on the risk of RBC transfusion after controlling for patient demographics, comorbidities, admission characteristics, use of IV or oral iron and hospitalization severity markers. Results: Among the 24,814 EPO and 2,990 DARB study patients, mean age and gender distribution at admission were similar (age: EPO 65.3 years, DARB 64.5 years; %women: EPO 53%, DARB 55%). Mean cumulative dose per inpatient stay was EPO 61,656 ± 50,274 Units and DARB 259 ± 340 mcg. RBC transfusions occurred in 37.9% of EPO patients compared to 39.8% of DARB patients (p=0.0404). Transfused EPO patients received a mean of 2.24 units versus 2.20 units for DARB patients (p=0.2111). After adjusting for covariates, the multivariate model confirmed that DARB treatment was associated with a higher risk of transfusion compared to EPO (odds ratio: 1.2, 95% CI: 1.1–1.3, p=0.0007). Conclusions: This analysis of inpatients with cancer indicates DARB treatment is associated with a higher risk of receiving RBC transfusion compared to treatment with EPO. [Table: see text]

Canine red blood cell transfusion practice

1996 ◽  
Vol 32 (4) ◽  
pp. 303-311 ◽  
Author(s):  
MB Callan ◽  
DA Oakley ◽  
FS Shofer ◽  
U Giger
Keyword(s):  
Adverse Events ◽  
Blood Cell ◽  
Red Blood Cell ◽  
Blood Cells ◽  
Transfusion Practice ◽  
Red Blood Cell Transfusion ◽  
Ineffective Erythropoiesis ◽  
Packed Red Blood Cells ◽  
The Mean ◽  
Rbc Transfusion

Red blood cell (RBC) transfusions in 307 dogs were reviewed. A total of 658 units of RBCs, including 474 (72%) units of packed red blood cells (PRBCs) and 184 (28%) units of whole blood (WB), were administered. Reasons for transfusion included hemorrhage (n = 222), hemolysis (n = 43), and ineffective erythropoiesis (n = 42). The mean pretransfusion packed cell volume (PCV) of dogs with hemolysis (13%) was significantly lower (p less than 0.0001) than the mean pretransfusion PCVs of dogs with hemorrhage (21%) or ineffective erythropoiesis (18%). The mean total volume of PRBCs transfused was significantly greater (p less than 0.03) in dogs with hemolysis. Overall, 187 (61%) of 307 dogs were discharged from the hospital. Cause of anemia, pretransfusion PCV, and total volume of blood administered did not appear to influence survival. However, the mean adjusted posttransfusion PCV of dogs with hemorrhage was significantly higher (p less than 0.001) in dogs that survived. Possible adverse events were observed during or shortly after RBC transfusion in 10 (3.3%) dogs; all reactions were mild and self-limiting, and none were hemolytic.

Evaluation of the Sepacell RS-2000® (LeukoConnect) Sterile Dock Leukocyte Reduction Filter Set with Red Blood Cells Collected using Trima.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4113-4113
Author(s):  
Sandy C. Campbell ◽  
Jennifer E. Mauldin ◽  
Kristy L. McShan ◽  
M. Dean Elfath
Keyword(s):  
Blood Cell ◽  
Ambient Temperature ◽  
Red Blood Cell ◽  
Limit Of Detection ◽  
Hold Time ◽  
Additional Time ◽  
Filtration Time ◽  
Group A ◽  
Filtration Condition ◽  
Group B

Abstract As automated red blood cell (RBC) collections become more prevalent, sterile dock filtration will continue to be an important means of leukoreduction (LR). This study evaluated the performance of the Baxter Sepacell RS-2000 sterile dock leukocyte reduction filter set with RBCs collected using Trima, which were filtered either immediately at ambient temperature, or refrigerated and then filtered 6–8 or 68–72 hours post-collection. 180 RBC units were collected using Trima (Gambro BCT, Lakewood, CO) and filtered with the Sepacell RS-2000 (Baxter Healthcare, Deerfield, IL). Units within Group A (n=60) were filtered at ambient temperature immediately after collection. Units within Group B (n=60) and C (n=60) were refrigerated and filtered at 6–8 or 68–72 hours post-collection respectively. Pre- and Post-filtration hematocrits were performed on the Cell-Dyn 3700 (Abbott Laboratories, Abbott Park, IL) to determine RBC percent recovery. Residual leukocytes in the final product were counted using either the FACSCalibur flow cytometer (BD Biosciences, San Jose, CA). Relevant data is presented in Table 1 below. This study demonstrated that the Sepacell RS-2000 (LeukoConnect) sterile dock filter yielded red cell units that met or exceeded the FDA and AABB standards for leukoreduction when filtering refrigerated red blood cell (RBC) units collected on Trima at 6–8 or 68–72 hours post-collection. 60 out of 60 (100%) LR-RBC units in Groups B and C contained residual white blood cell (WBC) counts at or below the limit of detection of 0.3 x 105. 55 of 60 (92%) LR-RBC units in Group A contained residual WBC &lt; 5x106. 38 of 60 (63 %) LR-RBC units within this group contained residual WBC = 1x106. The hold-time prior to ambient filtration for Group A averaged 1:37 ± 0:18. Filtration was initiated &lt; 3 hours post-collection for all units within this group. There is speculation that a correlation may exist between the temperature of the unit at the time of filtration and leukocyte reduction performance for this filtration condition. This correlation was not assessed by this study and warrants further investigation. It was also noted that 11 out of 180 total units (6%) achieved RBC recovery results slightly less than 85%. Unexpected variability in volume recovery for these units can be attributed to inadequate drainage time of the filter. Allowing additional time for complete drainage of the filter would be expected to result in all units achieving &gt; 85% recovery. Table 1 Parameters Group A Group B Group C Mean ± SD (n=60) (n=60) (n=60) Storage & Filtration Condition Ambient (&lt; 3hrs) 1–6°C (6–8hrs) 1–6°C (68–72hrs) Filtration Time (min) 11 ± 1 24 ± 5 27 ± 6 Residual WBC count (1x106) 1.81 ± 3.33 0.30 ± 0.00 0.30 ± 0.00 % RBC Recovery 88 ± 2 87 ± 2 88 ± 2

Red Blood Cell Variables in Young and Mature High-Trained Football Players

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3749-3749
Author(s):  
Janet G. Grudeva ◽  
Nickolay Boyadjiev ◽  
Zdravko Taralov ◽  
Ilia Batashki
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
Red Blood Cell ◽  
Football Players ◽  
Working Capacity ◽  
Blood Cell Count ◽  
Corpuscular Haemoglobin ◽  
Group A ◽  
Mean Corpuscular Haemoglobin ◽  
Group B

Abstract A suboptimal values of the haematological variables has often been recorded in young athletes involved in intense physical activity. There have even been reports of “sports anemia” associated with intensive physical training. There are profound studies describing the haematological changes of the soccer players after training or 90 min match. Our previous studies demonstrated lower values of red blood cell count (RBC), packed cell volume (HCT), haemoglobin concentration (HGB) in highly trained football players than in untrained controls of the same pubescent age. THE AIM: It was a matter of interest to evaluate the haematological status of 2314 football players (15.11±2.89 yrs old) and to compare the results for pre-pubescent, pubescent and mature boys recruited in the study and also to relate the values obtained to the individulal aerobic functional capacity. MATERIAS: A total of 2314 highly trained football players were included in the study. Their mean±SD age, weight, and BMI were: 15.11±2.89 yrs, 56.33±13.28 kg, and 19.62±2.58 kg/m2. The sportsmen were divided into three groups in accordance with their age: pre-pubescent (9–14 years) group A (n=1178) − 13.22±1.05 yrs (158.6±12.6 months); pubescent (15–19 years) group B (n=1029) − 16.57±1.04 yrs (198.9±12.6 months); and mature (20–35 years) group C (n=107) − 24.30±3.78 yrs (291.6±45.3 months) old. Profound clinical examination of all sportsmen was performed at the day before obtaining the blood samples. Haematological variables including RBC, HCT, HGB, mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin content (MCHC), white blood cell count (WBC) and platelet count (PLT) were analysed on a Sysmex K800 (Japan) analyser. Each football player passed also PWC170-test for assessment the working capacity on AT-104 Spiro-Ergo equipment (Schiller, Switzerland). RESULTS: All haematological variables in the groups were found in normal ranges, but the RBC was highest in group B (5.17±0.28 *1012/l vs. 5.03±0.28 *1012/l for group A, and 5.08±0.41 *1012/l for group C). Group A demonstrated not only lowest values for the RBC, but also for the HGB (144.7±6.4 g/l vs. 149.1±6.0 g/l for group B, and 151.8±7.5 g/l for group C, P&lt;0.001), and for HCT (0.437±0.02 vs. 0.451±0.02 for group B, and 0.451±0.03 for group C, P&lt;0.001). Group A demonstrated similar values for the above basic red blood cell parameters to these measured for great male group of same age. The pre-pubescent football players (group A) had lower MCV (87.1±2.8 fl), than the players of group B (87.5±2.9 fl) and than the players from group C (88.1±3.0 fl). No evidences for blood dilution as a result of long-term training had been found in groups B and C. There was not difference in the WBC and PLT between pre-pubescent, pubescent and mature footballers. The mature players (C-group) demonstrated higher PWC/kg than pre-pubescent (20.6±2.3 vs. 19.2±2.3 kgm/min/kg), and than pubescent boys (19.8±2.7 kgm/min/kg). Significant correlations were obtained between the age and HGB, and between the age and HCT in groups A (0.19 and 0.19 respectively) and B (0.24 and 0.15 respectively). Good correlations were found between RBC and PWC170/kg in all groups investigated. CONCLUSIONS: Pre-pubescent highly trained football players have lower values of the red blood cell variables than pubescent and mature footballers, which correlates with lower aerobic working capacity.

Fertility in Ex-Cryptorchids: Study of 159 Cases

1996 ◽  
Vol 63 (2) ◽  
pp. 214-219
Author(s):  
C. Milani ◽  
A. Bettella ◽  
A. Ferlint ◽  
G. Oliva ◽  
F. Aragona ◽  
...  
Keyword(s):  
Undescended Testis ◽  
Semen Analysis ◽  
Sperm Concentration ◽  
Previous Treatment ◽  
Bilateral Cryptorchidism ◽  
Late Treatment ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Very High

The Authors report their experience in the fertility evaluation of 159 men who underwent, during childhood, orchiopexy for cryptorchidism. Patients were divided into two groups. Group A consisted of 67 patients out of 442 subjected to orchiopexy between 1975 and 1983. Group B consisted of 92 patients out of 1052 evaluated for infertility. All patients were evaluated by semen analysis, testis ultrasound, FSH, LH, Testosterone. The percentage of normospermic patients in Group A was 51.7% and in Group B 14.7% (p < 0.001). When bilateral cryptorchidism was present the percentage of semen anomalies was very high: 16.6% and 40% of azoospermia in Group A and B respectively. In patients with monolateral cryptorchidism the mean testicular volume of the undescended testis is significantly lower than the contralateral one. This latter fact only is related to sperm concentration and is inversely proportional to FSH value. In monolateral cryptorchidism the sperm concentration seems to be unrelated to previous treatment (orchiopexy vs orchiectomy). Even if the Authors cannot exclude the possibility of testicular damage due to late treatment, they point out the possibility of a primary testicular anomaly. The involvement of the contralateral normally-descended testis seems to confirm this possibility which needs, however, to be confirmed through a structural study.

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