Androgens and liver tumors: Fanconi's anemia and non‐Fanconi's conditions

Abstract

The association between anabolic androgenic steroids and liver tumors was first noted in patients with Fanconi's anemia (FA). The hypotheses which led to this review were as follows: (1) androgen-treated individuals who do not have FA are also at risk of liver tumors; (2) parenteral as well as oral androgens may be responsible for liver tumors; (3) FA patients develop liver tumors after smaller and briefer androgen exposure than non-FA individuals; (4) the risk of hepatic neoplasms may depend on the specific androgen. Medline and Web of Science were searched for all cases of liver tumors associated with androgens. Information from individual cases was entered into a spreadsheet and descriptive statistical analyses were performed. Thirty-six FA cases and 97 non-FA cases with both nonhematologic disorders and acquired aplastic anemia (non-FA AA) were identified. The most common androgens were oxymetholone, methyltestosterone, and danazol. Hepatocellular carcinomas (HCC) were more often associated with oxymetholone and methyltestosterone, while adenomas were associated with danazol. Tumors were reported in six patients who received only parenteral and not oral androgens. FA patients were younger than non-FA patients when androgen use was initiated, and the FA patients developed tumors at younger ages. Non-AA patients were treated with androgens for longer periods of time, compared with FA and non-FA AA patients. All patients on anabolic androgenic steroids are at risk of liver tumors, regardless of underlying diagnosis. The magnitude of the risk cannot be determined from currently available data, because the number of patients receiving androgens is unknown. Am.

Reduced intensity conditioning is effective for hematopoietic SCT in dyskeratosis congenita-related BM failure

“…33 Hematopoietic growth factors may be useful in BMF. However, splenic peliosis and splenic rupture have been reported in two individuals with DKC, receiving androgens and G-CSF.…”

“…21,24,32 Although a trial of androgen therapy (for example, oxymetholone) may be considered first, while the preparation for allografting is underway. 33,34 The Working Party Severe Aplastic Anemia of the European Blood and Marrow Transplantation is conducting an extensive database and literature review of transplants performed worldwide in DKC. (E. Korthof, personal communication).…”

Effects of administering testosterone undecanoate in rats subjected to physical exercise: effects on the estrous cycle, motor behavior and morphology of the liver and kidney

“…Although they can be used therapeutically at low doses to treat aplastic anemia (Velazquez et al, 2004), osteoporosis (Berning et al, 2001;Kilbourne et al, 2007), and as antitumor agents in breast cancer (von Bueren et al, 2007) in women, the beneficial health effects of such doses contrast with the risks associated with excessive self-administered doses by women athletes.…”

Incidence of liver abnormalities in Fanconi anemia patients

“…In patients with no available donor, androgen treatment may improve blood cell counts [8]. It is now well-established that androgen treatment is a risk factor for liver abnormalities in both FA and non-FA patients [9][10][11][12][13][14]. Some studies have previously reported hepatic tumors in patients with FA [9,15,16], but little is known concerning other abnormalities of the livers of these patients.…”

“…Androgen treatment is a well-known risk factor for liver tumors [11] and the three patients with liver tumors described here received androgen treatment for 4, 6, and 30 years, respectively.…”