期刊
AMERICAN JOURNAL OF PHYSIOLOGY-ENDOCRINOLOGY AND METABOLISM
卷 315, 期 6, 页码 E1185-E1193出版社
AMER PHYSIOLOGICAL SOC
DOI: 10.1152/ajpendo.00272.2018
关键词
anemia; bone marrow; erythropoietin; erythroferrone; hepcidin; leu-kopenia
资金
- National Cancer Institute [CA171316]
- NATIONAL CANCER INSTITUTE [P30CA008748] Funding Source: NIH RePORTER
- NATIONAL HEART, LUNG, AND BLOOD INSTITUTE [K08HL132122] Funding Source: NIH RePORTER
Androgen deprivation therapy (ADT) is a mainstay of treatment for prostate cancer (PCa). As androgens stimulate erythropoiesis, ADT is associated with a reduction in hematocrit, which in turn contributes to fatigue and related morbidity. However, the mechanisms involved in ADT-induced reduction in erythropoiesis remain unclear. We conducted a 6-month prospective cohort study and enrolled men with PCa about to undergo ADT (ADT-Group) and a control group of men who had previously undergone prostatectomy for localized PCa and were in remission (Non-ADT Group). All participants had normal testosterone levels at baseline. Fasting blood samples were collected at baseline, 12 weeks and 24 weeks after initiation of ADT; samples were obtained at the same intervals from enrollment in the Non-ADT group. Blood count, iron studies, erythropoietin, erythroferrone and hepcidin levels were measured. Seventy participants formed the analytical sample (31 ADT, 39 Non-ADT). ADT was associated with a significant reduction in erythrocyte count (estimated mean difference = -0.2 x 10(6)cells/mu l; 95%CI = -0.3 to -0.1 x 10(6)cells/mu l; p < 0.001), hematocrit (-1.9%; 95%CI = -2.7 to -1.1%; p < 0.001) and hemoglobin (-0.6g/dl; 95%CI = -0.8 to -0.3g/dl; p < 0.001). Serum hepcidin concentration increased in the ADT-group (18ng/ml; p<0.001); however, iron concentrations did not change (-1.1 mu g/dl; p = 0.837). Ferritin levels increased in men on ADT (60ng/ml; p < 0.001). Iron binding capacity, transferrin saturation, erythroferrone and erythropoietin didn't change. Nine men undergoing ADT developed new-onset anemia. In conclusion, reduced proliferation of marrow erythroid progenitors leads to ADT-induced reduction in erythropoiesis. Future studies should evaluate the role of selective androgen receptor modulators in the treatment of ADT-induced anemia.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据