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Post-Transplant Events

Intensive glucose control after allogeneic hematopoietic stem cell transplantation: a retrospective matched-cohort study

Bone Marrow Transplantation volume 44, pages 105–111 (2009)Cite this article

Abstract

Some studies have shown that intensive glucose control (IGC) improves outcome in the intensive care unit setting. However, it is the benefit of IGC in hematopoietic SCT (HSCT) that is not well defined. Between June 2006 and May 2007, IGC was maintained prospectively after allogeneic HSCT and clinical outcomes were compared with a cohort matched for conditioning regimen, source of stem cells, age and relation to donor. A stratified Cox regression model was used. There were no significant differences in baseline clinical characteristics. The median age was 43.5 years in both groups. The primary diagnosis was a hematologic malignancy. Patients in the IGC group had a lower glucose level (least-square mean, 116.4 vs 146.8 mg per 100 ml, P<0.001) compared to the standard glucose control group. The incidences of documented infections and bacteremia were significantly lower in the IGC group (14 vs 46%, P=0.004, 9 vs 39%, P=0.002, respectively). IGC tended to reduce the incidence of renal dysfunction (19 vs 37%, P=0.36) and the elevation of C-reactive protein (18 vs 38%, P=0.13). This study suggests that IGC has may have a beneficial effect after HSCT. IGC should be evaluated further in a large prospective, randomized study.

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Acknowledgements

We thank the medical, nursing, data processing, laboratory and clinical staffs at the National Cancer Center Hospital for their important contributions to this study through dedicated care of the patients. We are indebted to Y Iisaka for assisting with data collection. We also thank S Saito for helping to prepare the article. This study was supported in part by grants from the Ministry of Health, Labor and Welfare, Japan.

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Authors and Affiliations

  1. Department of Hematology and Stem Cell Transplantation, Tokyo, Japan

    S Fuji, S-W Kim, S Mori, H Yokoyama, S Kurosawa, B Saito, T Takahashi, Y Heike, R Tanosaki, Y Takaue & T Fukuda

  2. Division of Nutritional Management, National Cancer Center Hospital, Tokyo, Japan

    S Kamiya & S Kuwahara

  3. Biostatistics and Epidemiology Section, Center for Cancer Control and Information Services, National Cancer Center Hospital, Tokyo, Japan

    K Yoshimura

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  1. S Fuji
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Correspondence to Y Takaue.

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Fuji, S., Kim, SW., Mori, S. et al. Intensive glucose control after allogeneic hematopoietic stem cell transplantation: a retrospective matched-cohort study. Bone Marrow Transplant 44, 105–111 (2009). https://doi.org/10.1038/bmt.2008.431

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