Skip to main content
SpringerLink
Log in

Androgen Therapy for Acute Myeloid and Hairy Cell Leukemia

  • Leukemia (PH Wiernik, Section Editor)
  • Published:
Current Treatment Options in Oncology Aims and scope Submit manuscript

Opinion statement

The purpose of this paper is to review the preclinical and clinical rationale for androgen therapy of acute myeloid (AML) and hairy cell leukemia (HCL). A major recent positive study should renew interest in this therapy, which has been reported to be effective in these leukemias for more than 50 years. Hopefully, renewed interest in this approach, which seems promising, will lead to well-designed modern studies that will precisely define a role for androgens in these leukemias. A recent large prospective, randomized study has demonstrated enhanced survival for elderly AML patients who present with WBC counts < 30,000/μL have improved overall survival when androgens are given post-remission, and numerous case reports suggest that androgens frequently restore normal peripheral blood counts in severely pancytopenic patients with HCL. Well-designed prospective studies are needed to precisely define which patients are most likely to benefit from androgen therapy and where in the treatment plan they should be incorporated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. •• Ratajczak MZ. Why are hematopoietic stem cells so ‘sexy’? On a search for developmental explanation. Leukemia. 2017;31:1671–7. This paper provides laboratory rationale for androgen therapy in leukemia

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Abdelbaset-Ismail A, Borkowska S, Janowska-Wieczorek A, Tonn T, Rodriguez C, Moniuszko M, et al. Novel evidence that pituitary gonadotropins stimulate human leukemic cells-studies of myeloid cell lines and primary patient AML and CML cells. Oncotarget. 2016;7(3):3033–46. https://doi.org/10.18632/oncotarget.6698.

    Article  PubMed  Google Scholar 

  3. Calado RT, Yewdell WT, Wilkerson KL, Regal JA, Kajigaya S, Stratakis CA, et al. Sex hormones acting on the TERT gene, increase telomerase activity in human primary hematopoietic cells. Blood. 2009;114(11):2236–43. https://doi.org/10.1182/blood-2008-09-178871.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Calado RT, Young NS. Telomere maintenance and human bone marrow failure. Blood. 2008;111(9):4446–55. https://doi.org/10.1182/blood-2007-08-019729.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Ziegler P, Schrezenmeier H, Akkad J, et al. Telomere elongation and clinical response to androgen treatment in a patient with aplastic anemia and a heterozygous hTERT gene mutation. Ann Hematol. 2012;91:1115–20.

    Article  PubMed  Google Scholar 

  6. Camitta BM, Thomas ED, Nathan DG, Gale RP, Kopecky KJ, Rappeport JM, et al. A prospective study of androgens and bone marrow transplantation for treatment of severe aplastic anemia. Blood. 1979;53(3):504–14.

    CAS  PubMed  Google Scholar 

  7. Paustian L, Chao MM, Hanenberg H, Schindler D, Neitzel H, Kratz CP, et al. Androgen therapy in Fanconi anemia: a retrospective analysis of 30 years in Germany. Pediatr Hematol Oncol. 2016;33(1):5–12. https://doi.org/10.3109/08880018.2015.1129567.

    Article  CAS  PubMed  Google Scholar 

  8. Li X, Leteurtre F, Rocha V, Guardiola P, Berger R, Daniel MT, et al. Abnormal telomere metabolism in Fanconi’s anemia correlates with genomic instability and the probability of developing severe aplastic anemia. Br J Haematol. 2003;120(5):836–45. https://doi.org/10.1046/j.1365-2141.2003.04225.x.

    Article  CAS  PubMed  Google Scholar 

  9. Bagby G, Alter B. Fanconi anemia. Semin Hematol. 2006;43(3):147–56. https://doi.org/10.1053/j.seminhematol.2006.04.005.

    Article  CAS  PubMed  Google Scholar 

  10. Aboudkhil S, Henry L, Zaid A, Bureaus JP. Effect of testosterone on growth of P388 leukemia cell line in vivo and in vitro. Distribution of peripheral blood T lymphocytes and cell cycle progression. Neoplasma. 2005;52(3):260–6.

    PubMed  Google Scholar 

  11. Lisukov IA, Tsyrlova IG, Kozlov VA. Effect of androgens on the development of leukemia in AKR-strain mice. Eksp Onkol. 1986;8:71–3.

    CAS  PubMed  Google Scholar 

  12. Blagosklonny MV, Neckers LM. Cytostatic and cytotoxic activity of sex steroids against human leukemia cell lines. Cancer Lett. 1994;76(2-3):81–6. https://doi.org/10.1016/0304-3835(94)90381-6.

    Article  CAS  PubMed  Google Scholar 

  13. Mossuz P, Cousin F, Castinel A, Chauvet M, Sotto MF, Polack B, et al. Effects of two sex steroids (17 beta estradiol and testosterone) on proliferation and clonal growth of the human monoblastic leukemia cell line, U937. Leuk Res. 1998;22(11):1063–72. https://doi.org/10.1016/S0145-2126(98)00101-5.

    Article  CAS  PubMed  Google Scholar 

  14. He Q, Jiang DA. Novel aminosteroid is active for proliferation inhibition and differentiation of human acute myeloid leukemia HL-60 cells. Leuk Res. 1999;23(4):369–72. https://doi.org/10.1016/S0145-2126(98)00160-X.

    Article  CAS  PubMed  Google Scholar 

  15. Danel L, Martin P, Escrich E, Tubiana N, Fiè D, Saez S. Androgen, estrogen and progestin binding sites in human leukemic cells. Int J Cancer. 1981;27(6):733–41. https://doi.org/10.1002/ijc.2910270602.

    Article  CAS  PubMed  Google Scholar 

  16. Sotto JJ, Hollard D, Schaerer R, Bensa JC, Seigneurin D. Androgens and prolonged complete remissions in acute nonlymphoblastic leukemias. Results of a systematic treatment with stanozolol associated with chemotherapy. Nouv Rev Fr Hematol. 1975;15(1):57–72.

    CAS  PubMed  Google Scholar 

  17. Hollard D, Sotto JJ, Berthier R, Leger J, Michallet M. High rate of long-term survivals in AML treated by chemotherapy and androgenotherapy. A pilot study. Cancer. 1980;45(7):1540–8.

  18. Montastruc A, Reiffers J, Stoppa AM, et al. Treatment of acute myeloid leukemia in elderly patients: the influence of maintenance therapy (BGM 84 protocol). Nouv Rev Fr Hematol. 1990:147–52.

  19. Mandelli F, Amadori S, Dini E, Grignani F, Leoni P, Liso V, et al. Randomized clinical trial of immunotherapy and androgenotherapy for remission maintenance in acute non-lymphocytic leukemia. Leuk Res. 1981;5(6):447–52. https://doi.org/10.1016/0145-2126(81)90115-6.

    Article  CAS  PubMed  Google Scholar 

  20. Hayat M, Jehn U, Willemze R, Haanen C, Zittoun R, Monconduit M, et al. A randomized comparison of maintenance treatment with androgens, immunotherapy, and chemotherapy in adult acute myelogenous leukemia. Cancer. 1986;58(3):617–23. https://doi.org/10.1002/1097-0142(19860801)58:3<617::AID-CNCR2820580304>3.0.CO;2-1.

    Article  CAS  PubMed  Google Scholar 

  21. Pavlovsky S, Scaglione C, Eppinger-Helft M, et al. Androgen therapy during myeloblastic leukemia remission induced by two drug combinations. Medicina (Bs Aires). 1981;41:11–8.

    CAS  Google Scholar 

  22. •• Pigneux A, Béné MC, Guardiola P, et al. Addition of androgens improves survival in elderly patients with acute myeloid leukemia: A GOELAMS study. J Clin Oncol. 2017;35:387–93. This paper demonstrates that elderly patients with AML who present with WBC counts < 30,000/μL have increased survival with androgen therapy than without it.

    Article  PubMed  Google Scholar 

  23. • Jahic A, Iljazovic E, Hasic S, et al. Prognostic parameters of acute myeloid leukaemia at presentation. Med Arch. 2017;71:20–4. This paper demonstrates that females have a poorer prognosis with AML than do males

    Article  PubMed  PubMed Central  Google Scholar 

  24. Manoharan A. Androgens in hairy cell leukaemia: an overlooked treatment ? Eur J Haematol. 1989;42(2):212–4.

    Article  CAS  PubMed  Google Scholar 

  25. Feffer SE, Westring DW, Lee AC, Lin JHA. Case of leukemic reticuloendotheliosis responding to oxymetholone. Cancer. 1982;50(3):396–400. https://doi.org/10.1002/1097-0142(19820801)50:3<396::AID-CNCR2820500303>3.0.CO;2-N.

    Article  CAS  PubMed  Google Scholar 

  26. Magee MJ, Mackenzie S, Filippa DA, et al. Hairy cell leukemia. Durability of response to spelnectomy in 26 patients and treatment of relapse with androgens in six patients. Cancer. 1985;56(11):2557–62. https://doi.org/10.1002/1097-0142(19851201)56:11<2557::AID-CNCR2820561103>3.0.CO;2-T.

    Article  CAS  PubMed  Google Scholar 

  27. Lenner P, Osterman B, Roos G. Response to oxymetholone in hairy cell leukaemia. Scand J Haematol. 1985;35(3):374–5.

    Article  CAS  PubMed  Google Scholar 

  28. Lusch CJ, Ramsey HE, Katayama I. Leukemic reticuloendotheliosis. Report of a case with peripheral blood remission on androgen therapy. Cancer. 1978;41(5):1964–6. https://doi.org/10.1002/1097-0142(197805)41:5<1964::AID-CNCR2820410541>3.0.CO;2-J.

    Article  CAS  PubMed  Google Scholar 

  29. Gardner FH, Pringle JC Jr. Androgens and erythropoiesis. Arch Intern Med. 1961;107(6):846–62. https://doi.org/10.1001/archinte.1961.03620060046007.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cancer Research Foundation, 43 Longview Lane, Chappaqua, Bronx and Chappaqua, New York, NY, 10514, USA

    Peter H. Wiernik MD

Authors
  1. Peter H. Wiernik MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter H. Wiernik MD.

Ethics declarations

Conflict of Interest

Peter H. Wiernik declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Leukemia

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Wiernik, P.H. Androgen Therapy for Acute Myeloid and Hairy Cell Leukemia. Curr. Treat. Options in Oncol. 19, 4 (2018). https://doi.org/10.1007/s11864-018-0519-z

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11864-018-0519-z

Keywords

Search

Navigation