Male Fertility and Fatherhood in Chronic Myeloid Leukemia: Current Understanding and Future Perspectives

Simple Summary In this review, the authors collected and demonstrated evidence concerning the effect of chronic myeloid leukemia (CML) and its treatment options on fertility in male patients. This became increasingly important as we began observing this disease in younger adults. We provide an overview and draw conclusions regarding different medications and treatment options and how these may affect the ability to conceive. This information is crucial for healthcare workers and patients, as it must be disclosed to patients when starting them on one of these agents.Abstract Chronic myeloid leukemia (CML), while traditionally a disease of the elderly, has recently risen in incidence among younger patients. Hence, fertility concerns have emerged considering the disease process and treatments, especially with the current scarce and conflicting recommendations. This review explores the impact of CML treatments including the first-line tyrosine kinase inhibitors (TKIs) and other treatments on male fertility in chronic myeloid leukemia (CML) patients. The aim of this review was to compile the available evidence on male fertility to ultimately tailor treatment plans for male CML patients for whom fertility and future chances for conception pose a concern. The data available on the conventional and newer TKIs to address fertility concerns were reviewed, particularly the potential long- and short-term effects. Also, the possible side effects on subsequent generations were a crucial focus point of this review to reach a more comprehensive CML management approach. We found and compared the evidence on TKIs approved to treat CML. We also reported the effects of hydroxyurea, interferon, and transplantation, which are considered second-line treatments. Our findings suggest that these drugs might have an undiscovered effect on fertility. More research with larger sample sizes and longer follow-up periods is essential to solidify our understanding of these effects.