Childhood cancer survivorship and late effects: The landscape in India in 2020.

Survivorship care is a major area of focus in the holistic management of childhood cancer with current knowledge and information almost exclusively from high-income countries. In this review, we summarize the state of scientific knowledge, service delivery, advocacy initiatives, and research efforts in this field in India. Twenty-one single-center studies published until today (20 in the last decade) confirm some of the well-documented issues in childhood cancer survivors and highlight the high prevalence of hepatitis B and hepatitis C infection in our survivors.

Very small embryonic-like stem cells (VSELs) detected in azoospermic testicular biopsies of adult survivors of childhood cancer.

Background: Infertility is a known side-effect of oncotherapy in cancer survivors, and often compromises the quality of life. The present study was undertaken to detect very small embryonic-like stem cells (VSELs) in testicular biopsies from young adult survivors of childhood cancer who had azoospermia. VSELs have been earlier reported in human and mouse testes.

Quiescent very small embryonic-like stem cells resist oncotherapy and can restore spermatogenesis in germ cell depleted mammalian testis.

Adult mouse and human testes harbor relatively quiescent, pluripotent very small embryonic-like stem cells (VSELs), in addition to actively dividing spermatogonial stem cells (SSCs). Here we report that various oncotherapy regimens in human cancer patients (n=7) and busulphan treatment (25mg/Kg body weight) in eight weeks old male mice (n=15) selectively affects actively dividing SSCs, spermatogonia, haploid germ cells and somatic microenvironment resulting in germ cell aplasia, whereas VSELs are unaffected and persist in otherwise germ cell depleted testis. Testicular VSELs are 2-5 µm in size, have high nucleo-cytoplasmic ratio, SCA-1+/CD45-/LIN- (mice), CD133+/CD45-/LIN- (human survivors of childhood cancer) and express various pluripotent transcripts including OCT-4A.