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Transplant Toxicities

Clinical impact of hyperglycemia on days 0–7 after allogeneic stem cell transplantation

Bone Marrow Transplantation volume 52, pages 1156–1163 (2017)Cite this article

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Abstract

In order to clarify the association between hyperglycemia during the early period after allogeneic stem cell transplantation (allo-SCT) and adverse outcomes, we retrospectively analyzed 563 consecutive patients who underwent allo-SCT at our institute between 2008 and 2015. Patients were categorized into three groups according to mean fasting blood glucose levels on days 0–7 (normoglycemia group<110 mg/dL, n=347; mild hyperglycemia group 110–149 mg/dL, n=192 and moderate/severe hyperglycemia group≥150 mg/dL, n=24). The median follow-up was 2.7 years. Patients in the moderate/severe hyperglycemia group had significantly worse characteristics. The cumulative incidences of 2-year non-relapse mortality (NRM) and the probabilities of 2-year overall survival (OS) in the normoglycemia, mild hyperglycemia and moderate/severe hyperglycemia groups were 7.5%, 19% and 29%, respectively (P<0.01), and 69%, 53% and 33%, respectively (P<0.01). In multivariate analyses, hyperglycemia was an independent predictor of high NRM (vs normoglycemia; mild hyperglycemia, hazard ratio (HR) 2.56, 95% confidence interval (CI) 1.56–4.18; moderate/severe hyperglycemia, HR 4.46, 95% CI 1.92–10.3) and poor OS (vs normoglycemia; mild hyperglycemia, HR 1.54, 95% CI 1.14–2.07; moderate/severe hyperglycemia, HR 1.61, 95% CI 0.89–2.91). In conclusion, hyperglycemia on days 0–7 after allo-SCT was associated with inferior outcomes.

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Acknowledgements

This work was supported by Grants from the National Cancer Research and Development Fund (26-A-26) and the Advanced Clinical Research Organization.

Author contributions

AK and SF designed this study and analyzed the data; all authors wrote the manuscript.

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Authors and Affiliations

  1. Department of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan

    A Kawajiri, S Fuji, Y Tanaka, C Kono, T Hirakawa, T Tanaka, R Ito, Y Inoue, K Okinaka, S Kurosawa, Y Inamoto, S-W Kim, T Yamashita & T Fukuda

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  1. A Kawajiri
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  2. S Fuji
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  3. Y Tanaka
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  4. C Kono
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  7. R Ito
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Correspondence to S Fuji.

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Additional information

Statement of prior presentation: Presented in abstract form at the 77th annual meeting of the Japanese Society of Hematology, Kanazawa, Japan on October 18, 2015.

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Kawajiri, A., Fuji, S., Tanaka, Y. et al. Clinical impact of hyperglycemia on days 0–7 after allogeneic stem cell transplantation. Bone Marrow Transplant 52, 1156–1163 (2017). https://doi.org/10.1038/bmt.2017.27

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