Pediatric males receiving hematopoietic stem cell transplant lose their male disadvantage in disease risk after the procedure: A retrospective observational study. Issue 2 (5th March 2022)

• Record Type: Journal Article
• Authors: De Nardi, Laura; Simeone, Roberto; Torelli, Lucio; Maestro, Alessandra; Zanon, Davide; Barbi, Egidio; Maximova, Natalia
• Is Part Of: International journal of cancer. Volume 151:Issue 2(2022)
• Page Start: 191
• Page End: 199
• Publication Date: 2022-03-05
• Subjects: cancer risk -- gonadal impairment -- male disadvantage -- sex disparity -- transplant‐related outcomes; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.33978
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract: Sex differences play a relevant role in cancer susceptibility, incidence and survival. Exploring such differences is difficult because of the close interplay of genetic, epigenetic and hormonal factors. However, a better understanding of the role of such disparities in cancer mechanisms could improve its prevention and therapy. Our study explores how sex differences in pediatric outcomes vary after undergoing first and advanced‐line therapy for hematological malignancies. The primary goal was to evaluate if sex differences in pediatric outcomes after first‐line therapy persist after allogeneic hematopoietic stem cell transplantation (HSCT). The secondary goal was to analyze sex differences in disease risk at onset and pediatric outcomes after first‐line therapy to compare our results with the literature's reported results. Among a total of 485 patients (280 males, 205 females) admitted for hematological malignancies, disease risk at the onset was significantly higher in males ( P < .05). One hundred and seventy‐four patients (111 males and 63 females) had a high‐risk disease requiring HSCT. Before HSCT, all patients underwent myeloablative conditioning, which substantially impaired gonadal function. Although the number of boys undergoing HSCT was almost double that of girls, there were no sex‐related differences in overall survival, cancer relapse and complications after HSCT exposure ( P > .05). These findings suggest that the existing sex differences in cancer risk ab initio can be somehow flattened by a conditioning regimen, shedding new light on the role of hormonal factors in cancer mechanism and management. Abstract : What's new? Sex differences resulting in a male disadvantage have been observed in cancer susceptibility, incidence and survival. A better understanding of the role of sex differences in cancer mechanisms could improve prevention and therapy. This pediatric oncological population‐based study suggests that the existing sex differences in cancer risk ab initio can be somehow flattened by a myeloablative conditioning regimen before hematopoietic stem cell transplantation, which substantially impairs gonadal function. The findings shed new light on the role of hormonal factors in cancer mechanisms and management, suggesting a major role of androgens in cancer relapse for pediatric hematological malignancies.