Pre-transplant testosterone and outcome of men after allogeneic stem cell transplantation
Testosterone is an important determinant of endothelial function and vascular health in men. As both factors play a role in mortality after allogeneic stem cell transplantation (alloSCT), we retrospectively evaluated the impact of pre-transplant testosterone levels on outcome in male patients underg...
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| Main Authors: | , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
2020
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| In: |
Haematologica
Year: 2020, Volume: 105, Issue: 5, Pages: 1454-1464 |
| ISSN: | 1592-8721 |
| DOI: | 10.3324/haematol.2019.220293 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3324/haematol.2019.220293 Verlag, lizenzpflichtig, Volltext: http://www.haematologica.org/content/105/5/1454 
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| Author Notes: | Aleksandar Radujkovic, Lambros Kordelas, Julia Krzykalla, Axel Benner, David Schult, Joshua Majer-Lauterbach, Dietrich W. Beelen, Carsten Müller-Tidow, Christian Kasperk, Peter Dreger and Thomas Luft |
| Summary: | Testosterone is an important determinant of endothelial function and vascular health in men. As both factors play a role in mortality after allogeneic stem cell transplantation (alloSCT), we retrospectively evaluated the impact of pre-transplant testosterone levels on outcome in male patients undergoing alloSCT. In the discovery cohort (n=346), an impact on outcome was observed only in the subgroup of patients allografted for acute myeloid leukemia (AML) (n=176, hereafter termed ‘training cohort’). In the training cohort, lower pre-transplant testosterone levels were significantly associated with shorter overall survival (OS) [hazard ratio (HR) for a decrease of 100 ng/dL: 1.11, P=0.045]. This was based on a higher hazard of non-relapse mortality (NRM) (cause-specific HR: 1.25, P=0.013), but not relapse (cause-specific HR: 1.06, P=0.277) in the multivariable models. These findings were replicated in a confirmation cohort of 168 male patients allografted for AML in a different center (OS, HR: 1.15, P=0.012 and NRM, cause-specific HR: 1.23; P=0.008). Next, an optimized cut-off point for pre-transplant testosterone was derived from the training set and evaluated in the confirmation cohort. In multivariable models, low pre-transplant testosterone status (<250 ng/dL) was associated with worse OS (hazard ratio 1.95, P=0.021) and increased NRM (cause-specific HR 2.68, P=0.011) but not with relapse (cause-specific HR: 1.28, P=0.551). Our findings may provide a rationale for prospective studies on testosterone/androgen assessment and supplementation in male patients undergoing alloSCT for AML. |
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| Item Description: | Pre-published: July 11, 2019 Gesehen am 03.06.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1592-8721 |
| DOI: | 10.3324/haematol.2019.220293 |