Published in
Springer Nature [academic journals on nature.com], Bone Marrow Transplantation, 2(59), p. 255-263, 2023
DOI: 10.1038/s41409-023-02154-6
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The impact of pre-transplantation diabetes and obesity on acute graft-versus-host disease, relapse and death after allogeneic hematopoietic cell transplantation: a study from the EBMT Transplant Complications Working Party
,
Tapani Ruutu ,
Christophe Peczynski ,
William Boreland ,
Nicolaus Kröger,
Didier Blaise ,
Thomas Schroeder,
Régis Peffault de Latour,
Tobias Gedde-Dahl,
Aleksandr Kulagin ,
Henrik Sengeløv,
Ibrahim Yakoub-Agha ,
Jürgen Finke ,
Matthias Eder,
Grzegorz Basak
and other authors.
Full text: Unavailable
Abstract
AbstractObesity and diabetes can modulate immune responses, which may impact allogeneic HCT outcomes and GvHD. From the EBMT registry, we included 36,539 adult patients who underwent allogeneic HCT for a hematological malignancy between 2016 and 2020. Of these, 5228 (14%) had obesity (BMI ≥ 30 kg/m2), 1415 (4%) had diabetes (requiring treatment with insulin or oral hypoglycemics), and 688 (2%) had obesity + diabetes pre-transplantation. Compared with patients without diabetes or obesity, the hazard ratio (HR) of grade II–IV acute GvHD was 1.00 (95% confidence interval [CI] 0.94–1.06, p = 0.89) for patients with obesity, 0.95 (CI 0.85–1.07, p = 0.43) for patients with diabetes, and 0.96 (CI 0.82–1.13, p = 0.63) for patients with obesity + diabetes. Non-relapse mortality was higher in patients with obesity (HR 1.08, CI 1.00–1.17, p = 0.047), diabetes (HR 1.40, CI 1.24–1.57, p < 0.001), and obesity + diabetes (HR 1.38, CI 1.16–1.64, p < 0.001). Overall survival after grade II–IV acute GvHD was lower in patients with diabetes (HR 1.46, CI 1.25–1.70, p < 0.001). Pre-transplantation diabetes and obesity did not influence the risk of developing acute GvHD, but pre-transplantation diabetes was associated with poorer survival after acute GvHD.