Myelodysplastic syndrome treated effectively with testosterone enanthate.

Area of Science:

• Hematology
• Endocrinology

Background:

• Myelodysplastic syndromes (MDS) are a group of clonal hematopoietic stem cell disorders.
• Anemia and thrombocytopenia are common complications of MDS.
• Late-onset hypogonadism can exacerbate symptoms in elderly men.

Observation:

• A 70-year-old male with low-risk MDS experienced progressive anemia and thrombocytopenia.
• Initial treatment with methenolone acetate was ineffective.
• The patient presented with symptoms of late-onset hypogonadism.

Findings:

• Switching to testosterone enanthate for testosterone replacement therapy (TRT) led to significant improvements in anemia and thrombocytopenia.
• Mean platelet count increased from 2.36 ± 0.45 × 10(4) to 3.83 ± 0.78 × 10(4) /µL.
• Mean hemoglobin increased from 11.7 ± 0.81 to 15.2 ± 1.00 g/dL, reducing transfusion needs.

Implications:

• Testosterone enanthate may serve as an alternative therapeutic option for men with MDS, particularly those with hypogonadism.
• TRT demonstrated a positive effect on platelet counts in an MDS patient.
• This case highlights a potential novel benefit of TRT in managing hematological parameters in MDS.