The anti‐oestrogen tamoxifen produces haemodilution in normal postmenopausal women

Abstract

Abstract. Grey AB, Evans MC, Kyle C, Reid, IR (University of Auckland, Auckland, New Zealand). The anti-oestrogen tamoxifen produces haemodilution in normal postmenopausal women. J Intern Med 1997; 242: 383-8. Objectives.To report the effects of the anti-oestrogen tamoxifen on biochemical and haematological parameters. Design. Randomized, double-blind comparison of tamoxifen 20 mg per day and placebo, over two years. Setting. A university hospital. Subjects. Forty-six healthy late-postmenopausal women (mean, SD time since menopause; 11, seven years). Main outcome measures. Blood specimens were drawn in the fasting state at baseline, six months and two years for measurement of haemoglobin, haematocrit, erythrocyte mean cell volume, mean erythrocyte haemoglobin, leucocyte count, platelet count, urea, electrolytes, creatinine and albumin.Results. There was a significant decline in the haemoglobin concentration in the tamoxifen group (Ϫ4.4, 1.2 g/L; mean, SE) and its levels were lower in this group than in those receiving placebo (P ϭ 0.004). Similarly, haematocrit, erythrocyte count and total leucocyte count were lower in those on placebo (P ϭ 0.002, P ϭ 0.01 and P ϭ 0.01, respectively) and platelet count showed a similar trend (P ϭ 0.08). In the tamoxifen group, the level of serum albumin fell significantly (Ϫ2.2, 0.4 g/L) and was lower throughout the study than that in the placebo group (P ϭ 0.006). That of serum urea tended to fall (Ϫ0.4, 0.2 mmol L) but the between-groups comparison was not significant (P ϭ 0.18). Conclusions. These data suggest that tamoxifen exerts a haemodilutory effect in normal postmenopausal women. Since a similar effect has been reported in response to postmenopausal oestrogen therapy, it is likely that the observed changes represent another oestrogenic effect of tamoxifen in postmenopausal women. Haemodilution may contribute to the reduced incidence of cardiovascular disease reported in tamoxifen-treated women, and, therefore, its assessment in the new oestrogen agonists/antagonists being developed for cardiovascular disease prevention may be important.

Case Studies in Physiology: Training adaptation in an elite athlete after breast cancer diagnosis

“…Despite this improvement, T0 values were not reached, contrary to what occurred in the case study of Savage, Dittus and Lakoski (25), in which the athlete recovered her initial hemoglobin levels after the end of treatment. Our results agree with those reported by Grey et al (26), who showed in their research that women with BC treated with ET suffered hemodilution, presenting significantly lower erythrocyte and hemoglobin values than the control group. The fact that our athlete was still in treatment with ET could explain the results at a hematological level.…”

Mean platelet volume increase after tamoxifen, but not after anastrazole in adjuvant therapy of breast cancer

“…Grey et al [12] reported the effects of tmx on biochemical and hematological parameters. They found decline of Hb, Hct, RBC, and WBC count after tmx treatment.…”

A potential chemopreventive activity of tamoxifen and amygdalin on oxidative stress in mammary carcinoma-induced in female mice.

“…In other hand, tamoxifen treatment revealed a drop in hematological values after 2 and 4 weeks of administration. Similarly, (Grey et al, 1997) who found a decline in Hemoglobin (Hb), hematocrit (HCT), red blood cell count (RBCs), and WBC count after tamoxifen treatment. Mannucci et al (1996) evaluated hemostatic factors in tamoxifen use; they showed that Hct, Hb, and platelet levels fell in the group treated with tamoxifen.…”