Page 301 - Haematologica May 2020

Testosterone and post-transplant outcome of men
models revealed no impact of gender on survival. In our cohorts of male patients allografted for AML, pre-trans- plant testosterone did not correlate with post-transplant relapse risk, suggesting an only limited, if any, impact on disease control. Conversely, and similar to the androgen maintenance trial,12 in our patients, the associations of testosterone with post-transplant survival were largely driven by increased NRM.
Besides its retrospective nature, several potential limita-
tions of our study need to be addressed. First, and as already stated above, we cannot definitely exclude the possibility that testosterone solely reflects the individual’s health and nutritional status prior to alloSCT, and thus unknown confounders cannot be ruled out. Second, due to its observational character, our study does not provide evidence for causality between testosterone and post- transplant outcome, and therefore our results here need to be interpreted with caution. Further, measurements of
A
B
Acute GvHD n=13
Acute GvHD n=9
Figure 3. Comparison of pre-transplant testosterone serum levels according to different non-relapse causes of death in the training and in the confirmation cohorts.
Non-relapse causes of death were grouped into three categories: severe infection/sepsis, death due to acute graft-versus-host disease (GvHD) (i.e. lethal complica- tions of acute GvHD and/or its treatment), and cardiovascular events. In both the training (A) and the confirmation (B) cohorts, as compared to patients not suc- cumbing to non-relapse mortality (NRM), serum levels of pre-transplant testosterone tended to be lower in patients who died of lethal complications of acute GvHD. Box plots are depicted. Number of patients/events for each group is indicated. P-values by Mann-Whitney U test.
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