Pre-transplant testosterone and outcome of men after allogeneic stem cell transplantation

• Verfasst von: Radujković, Aleksandar [VerfasserIn]
• Verfasst von: Kordelas, Lambros [VerfasserIn]
• Verfasst von: Krzykalla, Julia [VerfasserIn]
• Verfasst von: Benner, Axel [VerfasserIn]
• Verfasst von: Schult, David [VerfasserIn]
• Verfasst von: Majer-Lauterbach, Joshua [VerfasserIn]
• Verfasst von: Beelen, Dietrich W. [VerfasserIn]
• Verfasst von: Müller-Tidow, Carsten [VerfasserIn]
• Verfasst von: Kasperk, Christian [VerfasserIn]
• Verfasst von: Dreger, Peter [VerfasserIn]
• Verfasst von: Luft, Thomas [VerfasserIn]
• Titel: Pre-transplant testosterone and outcome of men after allogeneic stem cell transplantation
• Verf.angabe: 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
• Jahr: 2020
• Umfang: 11 S.
• Fussnoten: Pre-published: July 11, 2019 ; Gesehen am 03.06.2020
• Titel Quelle: Enthalten in: Haematologica
• Ort Quelle: Pavia : Ferrata Storti Foundation, 2014
• Jahr Quelle: 2020
• Band/Heft Quelle: 105(2020), 5, Seite 1454-1464
• ISSN Quelle: 1592-8721
• DOI: doi:10.3324/haematol.2019.220293
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1699284997

Abstract

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.