Stimulation of Erythropoiesis by Androgenic Hormones

Abstract

An increase in erythropoiesis has been observed following administration of androgenic hormones in animals and man. In women with advanced breast cancer treated with massive doses of androgenic hormones for prolonged periods, an unusual alteration in erythropoietic activity occurred. The increase in erythroid activity has been accompanied by clinical symptoms and signs characteristic of polycythemia. Associated with these clinical changes was evidence of increased production of red blood cells. There was an increase in hemoglobin, hematocrit, red blood cell count, reticulocytes, red cell volume and development of a normoblastic hyperplasia of the bone marrow. In some instances polycythemia occurred. The effect was intensified by combined administration of corticosteroid and androgenic hormones. The phenomenon did not occur in the absence of iron reserves. The observation in breast cancer provided the impetus to further investigations of effect in refractory anemias. Androgenic hormones were administered to 43 patients with anemia not responsive to the usual hematinic agents. Significant increases in hemoglobin, hematocrit, reticulocytes, red cell volume with restoration of normal or increased erythrocytic cellularity of the bone marrow occurred in 12 patients. Reticulocytosis or decreased transfusion requirements were noted in 7 patients. The diseases favorably affected were myelosclerosis, hypogonadism, leukemia, chronic renal disease, aplastic anemia and refractory anemia. Androgenic hormones are a specific stimulant to red cell production, and should be considered in the treatment of anemias not responsive to the usual measures. The mechanism of action of the phenomenon of stimulation of erythropoiesis by androgenic hormones is unexplained.