Short-Term Haematogical Effects of Androgen Deprivation and Radiotherapy in Prostate Cancer Patients

Gregory P Swanson,Kendall Hammonds,Sameer Jhavar

doi:10.4236/oju.2021.114011

Abstract

Androgen deprivation therapy (ADT) is known to cause a decline in hemoglobin (Hgb), but the effect on other blood parameters is less well studied. In the lab, androgen manipulation has an effect on leukocyte counts. We evaluated the effects of androgen ablation alone on Hgb, white blood cell (WBC), granulocyte, and lymphocyte counts in 99 prostate cancer patients. In addition, since radiation therapy decreases those counts, we evaluated whether the addition of ADT makes it worse, comparing 162 patients receiving both radiation and ADT to 149 patients with radiation alone. ADT alone did significantly (but minimally) cause a drop in the Hgb (~0.5 g/dl), the WBC (-0.39 × 103/μl) and granulocyte (-0.32 × 103/μl), but not the lymphocyte counts. The combination of ADT with radiation did cause a greater decline in the Hgb levels at the end of treatment, but at follow up there was no difference. There was no additional effect on WBC, granulocytes or lymphocyte counts. Our results confirm clinically that ADT alone has minimal effect on WBC and its components and that there is no synergistic detriment of androgen ablation on the effects of radiation therapy on those cells.

Highlights

Androgen deprivation therapy (ADT) has been shown to cause a decline in hemoglobin, leading to anemia in some patients [1] [2]
We evaluated the effects of androgen ablation alone on Hgb, white blood cell (WBC), granulocyte, and lymphocyte counts in 99 prostate cancer patients
Our analysis is on the effect of androgen ablation alone on leukocyte counts and whether androgen ablation enhanced the detrimental effects of radiation on those same counts

Summary

Introduction

Androgen deprivation therapy (ADT) has been shown to cause a decline in hemoglobin, leading to anemia in some patients [1] [2]. The effect on other blood parameters such as white blood cell (WBC) counts is less well studied. It has been shown that androgens can affect lymphocyte counts [6], in humans there has minimal documented effect. Despite its wide spread use, there is minimal clinical data on the effect of androgen deprivation on overall leukocyte (white blood cell), granulocyte (neutrophil) or lymphocyte counts. The question remains relevant with the current interest in enhancing the immunotherapy approaches to cancer treatment. With the widespread use of androgen ablation in prostate cancer, it raises the question as to the effects of androgen ablation on leukocyte counts and whether such treatment enhances the suppressive effects of radiation therapy on those parameters

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Discussion

Conclusion