Page 298 - Haematologica May 2020

A. Radujkovic et al.
Discussion
The present study is, to the best of our knowledge, the first to evaluate testosterone status in the context of out- come and mortality after alloSCT. So far, studies in the alloSCT setting have focused on the impact of chronic GvHD and its treatment on the androgen status,17 or have investigated the relationship between sex hormone levels
and overall gonadal function, mainly in the context of late complications after alloSCT.18,19 Evaluation of testosterone status in the context of outcome and mortality after alloSCT, therefore, appears to meet an unmet need, given that sex hormones are involved in the regulation of a wide range of physiological processes that affect metabolism, tissue and cardiovascular homeostasis, inflammatory and immune responses,20 and thus may interfere with alloSCT outcome.
AB
CD
EF
G
H
Figure 1. Impact of pre-transplant testosterone status on outcome measures after allogeneic stem cell transplantation (alloSCT) in the training and in the confir- mation cohorts. The cut-off point of 250 ng/dL was derived from the Heidelberg training cohort of men allografted for acute myeloid leukemia (AML) (n=176). It was used to stratify patients in low (<250 ng/dL) and high (≥250 ng/dL) pre-transplant testosterone groups, and then applied to an independent cohort of male AML patients who underwent alloSCT in the Essen center (confirmation cohort, n=168) (see Online Supplementary Figure S1). (A and C) Distribution of overall survival (OS) and progression-free survival (PFS) since transplant in the training cohort. (B and D) Distribution of OS and PFS since transplant in the confirmation cohort. (E and G) Incidence curves of non-relapse mortality (NRM) and relapse after alloSCT in the training cohort. (F and H) Incidence curves of NRM and relapse after alloSCT in the confirmation cohort. Curves of patients with low (<250 ng/dL) and high (≥250 ng/dL) pre-transplant testosterone status are shown in blue and in red, respec- tively.
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haematologica | 2020; 105(5)