Bone marrow insufficiency in the child and androgen therapy. Preliminary results of a prospective schedule of examination and treatment

Arch Fr Pediatr. 1976 Oct;33(8):761-9.

[Bone marrow insufficiency in the child and androgen therapy. Preliminary results
of a prospective schedule of examination and treatment]

[Article in French]

Girot R, Pecking A, Najean Y.

The preliminary results of a prospective study of androgen therapy in the
treatment of bone marrow insufficiency in children are reported. This study
includes 11 children with the Fanconi syndrome, 21 idiopathic and 3 with toxic
aplastic anaemia. Nine patients died early in the course of treatment. Impaired
liver function was observed in 28% of patients and virilization in 37% of
patients.

Hyperlipidemia due to oxymetholone therapy. Occurrence in a long-term hemodialysis patient.

JAMA. 1976 Aug 2;236(5):469-72.

Hyperlipidemia due to oxymetholone therapy. Occurrence in a long-term
hemodialysis patient.

Reeves RD, Morris MD, Barbour GL.

Marked hypertriglyceridemia and hypercholesterolemia accompanied by angina and a
left cerebral thrombosis occurred in a long-term hemodialysis patient following 5
1/2 weeks of oral treatment with oxymetholone, 100 mg/day, a synthetic androgen.
After androgen therapy was discontinued, over a three-month period, plasma lipid
values progressively decreased below pretreatment values, and clinical symptoms
disappeared. During rechallenge with oxymetholone, serum lipid values increased
substantially, and the lipoprotein pattern changed from a type IV to a type V.
Detailed lipid studies showed subnormal postheparin lipolytic activity and a
fast-migrating pre-beta-lipoprotein in a very-low-density lipoproteins (VLDL)
fraction. Because of the data linking lipid abnormalities to atherosclerosis and
the acceleration of atherosclerosis in long-term hemodialysis patients, great
caution should be exercised in administering androgenic steroids to these
patients.

Occurrence of primary hepatocellular cancer and peliosis hepatis after treatment with androgenic steroids.

S Afr Med J. 1976 Jul 24;50(32):1233-7.

Occurrence of primary hepatocellular cancer and peliosis hepatis after treatment
with androgenic steroids.

Kew MC, Van Coller B, Prowse CM, Skikne B, Wolfsdorf JI, Isdale J, Krawitz S,
Altman H, Levin SE, Bothwell TH.

Three patients are reported in whom treatment of Fanconi's anaemia with
androgenic steroids was complicated by the development of either primary
hepatocellular cancer (PHC) or peliosis hepatis. The first, a White woman aged 34
years, was found to have PHC after receiving first methyltestosterone and then
oxymetholone for a total period of 7 years. She died 4 months after the diagnosis
was made. The other 2 patients were White children who presented with peliosis
hepatis after receiving methyltestosterone and oxymetholone for 8 years and
oxymetholone for 5 years, respectively. Both died from their primary diseases
shortly after oxymetholone treatment was discontinued. Possible pathogenic
mechanisms involved in the development of these serious complications are
discussed and the therapeutic dilemma raised by their occurrence is emphasised.

Oxymetholone treatment in aregenerative anaemia. II. Remission and survival--a prospective study.

Scand J Haematol. 1976 Feb;16(2):90-100.

Oxymetholone treatment in aregenerative anaemia. II. Remission and survival--a
prospective study.

Hast R, Skårberg KO, Engstedt L, Jameson S, Killander A, Lundh B, Reizenstein P,
Udén AM, Wadman B.

This is a prospective multi-center study in which patients with aregenerative
anaemia were treated with a standardized high dosage regime of an anabolic
steroid (oxymetholone, Anasteron). 53 patients were included and divided into two
groups according to bone marrow cellularity. Furthermore the hypocellular group
was subdivided in order to make comparison with earlier studies possible. In the
hypocellular group, the frequency of remission was 56% and the 2-year-survival
from the onset of symptoms was 75%. This is longer than in some earlier studies,
perhaps because of possible differences in etiology and/or because of the effect
of systematic high dosage, long term androgen therapy. Patient selection was
minimized and was not considered to be of major importance. Patients with
hypercellular marrows, on the other hand, responded poorly to androgens. In this
group 63% died of acute leukaemia, which confirms earlier suggestions that this
form of aregenerative anaemia, frequently is of a preleukaemic nature.

Fanconi's familial hypoplastic anaemia with some unusual features.

Med J Aust. 1976 Jan 31;1(5):116-8.

Fanconi's familial hypoplastic anaemia with some unusual features.

Farrell GC.

A case of Fanconi's familial hypoplastic anaemia is described in a 48-year-old
woman who had the usual haematological and constitutional abnormalities of this
condition. Chromosomal studies on peripheral blood lymphocytes and direct marrow
preparations demonstrated the chromosomal breaks previously described. The age of
the patient and a congenital abnormality of breast development were unusual
features, while the discovery of a benign liver tumour at necropsy is of
interest, as the patient had received therapy with oxymetholone.

Hereditary angioedema: modification of clinical manifestations with androgens.

Birth Defects Orig Artic Ser. 1976;12(6):283-7.

Hereditary angioedema: modification of clinical manifestations with androgens.

Davis PJ, Davis FB, Charache P.

HAE is an autosomal dominant trait of decreased levels or function of circulating
and tissue C'1 esterase inhibitor. The clinical illness is characterized by
disabling episodes of peripheral, oropharyngeal and gut-wall edema. Long-term
fluoxymesterone treatment of 5 affected males (393 patient-months) and
oxymetholone treatment of 6 affected females (204 patient-months) has
significantly decreased the frequency of attacks of edema without substantive
side effects.

Peliosis hepatis, complicating treatment with anabolic steroids

Med Klin. 1975 Oct 3;70(40):1602-7.

[Peliosis hepatis, complicating treatment with anabolic steroids (author's
transl)]

[Article in German]

Kühböck J, Radaszkiewicz T, Walek H.

The clinical and pathological findings of peliosis hepatis are reported,
complicating a long-term treatment with an anabolic steroid in a 19 year old male
patient suffering from chronic aplastic anemia. Following a 15 months course of
oxymetholone (Anapolon) a cholestatic jaundice developed without regression
despite discontinuing the drug. 4 months later the patient expired as a
consequence of his hematologic disease. At autopsy the liver showed a parenchymal
type of peliosis hepatis with multiple blood filled cavities and focal liver cell
necroses. The pathogenesis of this rare condition is discussed by means of
literature demonstrating the hepatotoxic effect of C17-alkylated androgens.