Department of Internal Medicine, Montefiore Medical Center, Bronx, NY, USA.
Division of Hemato-Oncology, Blood Cancer Institute, Montefiore Einstein Comprehensive Cancer Center, Bronx, NY, USA.
J Cancer Res Clin Oncol. 2024 Aug 29;150(8):404. doi: 10.1007/s00432-024-05844-w.
To explore the potential of testosterone therapy in managing cytopenias in myelodysplastic neoplasm and investigate the link between hypogonadism and hematologic malignancies.
A case of a patient with intermediate-risk myelodysplastic neoplasm and hypogonadism treated with testosterone replacement therapy is presented. Testosterone, prostate specific antigen, and erythropoietin levels were checked prior to therapy initiation and 3 months after. Blood counts were monitored over time. This is followed by a literature review of testosterone use in myelodysplastic neoplasm and the prevalence of hypogonadism in hematologic malignancies.
The patient showed sustained improvement in anemia with testosterone therapy and reported subjective improvement in his weakness and fatigue. This improvement occurred even in the setting of an undetectable follow up erythropoietin level. His repeat prostate specific antigen levels remained low, while testosterone levels showed marked improvement. The literature review demonstrated positive response rates for testosterone in treating myelodysplastic neoplasm-related cytopenias, and showed a higher incidence of hypogonadism in hematologic malignancies.
Our review suggests that the use of testosterone in low and intermediate-risk myelodysplastic neoplasm is underexplored and poses to have significant potential as a future therapeutic agent, after careful consideration of risks and benefits. In addition, the incidence of hypogonadism in myelodysplastic neoplasm and its potential impact on exacerbating cytopenias in myelodysplastic neoplasm warrants further investigation.
探讨睾酮治疗骨髓增生异常综合征（MDS）伴血细胞减少的潜力，并探讨性腺功能减退与血液系统恶性肿瘤之间的联系。
报告一例中危 MDS 伴性腺功能减退患者，接受睾酮替代治疗。在开始治疗前和治疗后 3 个月检查了睾酮、前列腺特异性抗原和促红细胞生成素水平。同时监测血细胞计数随时间的变化。随后对 MDS 中睾酮的应用以及血液系统恶性肿瘤中性腺功能减退的患病率进行文献复习。
患者接受睾酮治疗后贫血持续改善，乏力和疲劳症状主观改善。即使在检测不到促红细胞生成素水平的情况下，这种改善仍然存在。他的重复前列腺特异性抗原水平仍然较低，而睾酮水平显著改善。文献复习表明，睾酮治疗 MDS 相关血细胞减少症的阳性反应率较高，并显示血液系统恶性肿瘤中性腺功能减退的发生率较高。
我们的综述表明，在仔细考虑风险和收益后，睾酮在低危和中危 MDS 中的应用尚未得到充分探索，具有很大的潜在应用前景。此外，MDS 中性腺功能减退的发生率及其对 MDS 中血细胞减少症的潜在影响需要进一步研究。
