Transfusion-dependent anemia after initiation of androgen deprivation therapy for metastatic prostate cancer.
Androgen deprivation therapy (ADT) is a commonly used treatment for metastatic prostate cancer. A 78-year-old patient with metastatic prostate cancer had transfusion-dependent anemia develop while on ADT. The patient also had hereditary hemorrhagic telangiectasia (HHT), with chronic gastrointestinal blood loss. Blood transfusions were required every 3 weeks for 4 months to keep hemoglobin levels above 8 g/dL, despite discontinuation of ADT. The anemia, which had been well managed with iron therapy before ADT, was worsened by the loss of bone marrow-stimulating testosterone effects. The case highlights testosterone's important role in erythrocyte production. Practitioners should monitor hemoglobin levels in patients undergoing ADT.
Curtis
Kelly K
KK
Division of Hematology/Oncology, Mayo Clinic, Scottsdale, Arizona 85259, USA.
Pruthi
Rajiv K
RK
Fonseca
Rafael
R
Gornet
Michael K
MK
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary*; D000368:Aged; D000726:Androgen Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D000740:Anemia / Q000097:blood / Q000139:chemically induced* / Q000628:therapy; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects* / Q000627:therapeutic use; D001803:Blood Transfusion; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000628:therapy; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D016729:Leuprolide / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D011471:Prostatic Neoplasms / Q000473:pathology*; D013683:Telangiectasia, Hereditary Hemorrhagic / Q000150:complications
D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D006454:Hemoglobins; D016729:Leuprolide