Pre-transplant diabetes mellitus is a risk factor for non-relapse mortality, especially infection-related mortality, after allogeneic hematopoietic SCT

K. Takano, S. Fuji, N. Uchida, H. Ogawa, K. Ohashi, T. Eto, H. Sakamaki, Y. Morishima, K. Kato, R. Suzuki, T. Fukuda

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Diabetes mellitus (DM) is a factor in the hematopoietic cell transplantation-comorbidity index. However, the impact of pre-transplant DM on morbidity and cause-specific non-relapse mortality (NRM) remains unclear. We performed a retrospective study with registry data that included a total of 7626 patients who underwent their first allogeneic hematopoietic SCT (HSCT) between 2007 and 2010. The median age was 44 years (range 0-88). Compared with patients without pre-transplant DM (non-DM group, n=7248), patients with pre-transplant DM (DM group, n=378) were older and were more likely to have high-risk disease, a reduced-intensity conditioning regimen and GVHD prophylaxis using tacrolimus. Multivariate analyses showed that pre-transplant DM was associated with increased risks of NRM (hazard ratio (HR)1.46, 95% confidence interval (CI) 1.21-1.76, P<0.01) and infection-related NRM (HR 2.08, 95% CI 1.58-2.73, P<0.01). The presence of pre-transplant DM was associated with an increased risk of overall mortality in a multivariate analysis (HR 1.55, 95% CI 1.35-1.78, P<0.01). In conclusion, pre-transplant DM was a risk factor for NRM, particularly infection-related mortality, after allogeneic HSCT. To improve the clinical outcome in patients with DM, the benefits of strict infection control and appropriate glycemic control should be explored in future trials.

Original languageEnglish
Pages (from-to)553-558
Number of pages6
JournalBone Marrow Transplantation
Volume50
Issue number4
DOIs
Publication statusPublished - Apr 4 2015
Externally publishedYes

Fingerprint

Diabetes Mellitus
Transplants
Mortality
Infection
Confidence Intervals
Multivariate Analysis
Cell Transplantation
Tacrolimus
Infection Control
Registries
Comorbidity
Retrospective Studies
Morbidity

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

Cite this

Pre-transplant diabetes mellitus is a risk factor for non-relapse mortality, especially infection-related mortality, after allogeneic hematopoietic SCT. / Takano, K.; Fuji, S.; Uchida, N.; Ogawa, H.; Ohashi, K.; Eto, T.; Sakamaki, H.; Morishima, Y.; Kato, K.; Suzuki, R.; Fukuda, T.

In: Bone Marrow Transplantation, Vol. 50, No. 4, 04.04.2015, p. 553-558.

Research output: Contribution to journalArticle

Takano, K, Fuji, S, Uchida, N, Ogawa, H, Ohashi, K, Eto, T, Sakamaki, H, Morishima, Y, Kato, K, Suzuki, R & Fukuda, T 2015, 'Pre-transplant diabetes mellitus is a risk factor for non-relapse mortality, especially infection-related mortality, after allogeneic hematopoietic SCT', Bone Marrow Transplantation, vol. 50, no. 4, pp. 553-558. https://doi.org/10.1038/bmt.2014.315
Takano, K. ; Fuji, S. ; Uchida, N. ; Ogawa, H. ; Ohashi, K. ; Eto, T. ; Sakamaki, H. ; Morishima, Y. ; Kato, K. ; Suzuki, R. ; Fukuda, T. / Pre-transplant diabetes mellitus is a risk factor for non-relapse mortality, especially infection-related mortality, after allogeneic hematopoietic SCT. In: Bone Marrow Transplantation. 2015 ; Vol. 50, No. 4. pp. 553-558.
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AU - Ogawa, H.

AU - Ohashi, K.

AU - Eto, T.

AU - Sakamaki, H.

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AU - Kato, K.

AU - Suzuki, R.

AU - Fukuda, T.

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N2 - Diabetes mellitus (DM) is a factor in the hematopoietic cell transplantation-comorbidity index. However, the impact of pre-transplant DM on morbidity and cause-specific non-relapse mortality (NRM) remains unclear. We performed a retrospective study with registry data that included a total of 7626 patients who underwent their first allogeneic hematopoietic SCT (HSCT) between 2007 and 2010. The median age was 44 years (range 0-88). Compared with patients without pre-transplant DM (non-DM group, n=7248), patients with pre-transplant DM (DM group, n=378) were older and were more likely to have high-risk disease, a reduced-intensity conditioning regimen and GVHD prophylaxis using tacrolimus. Multivariate analyses showed that pre-transplant DM was associated with increased risks of NRM (hazard ratio (HR)1.46, 95% confidence interval (CI) 1.21-1.76, P<0.01) and infection-related NRM (HR 2.08, 95% CI 1.58-2.73, P<0.01). The presence of pre-transplant DM was associated with an increased risk of overall mortality in a multivariate analysis (HR 1.55, 95% CI 1.35-1.78, P<0.01). In conclusion, pre-transplant DM was a risk factor for NRM, particularly infection-related mortality, after allogeneic HSCT. To improve the clinical outcome in patients with DM, the benefits of strict infection control and appropriate glycemic control should be explored in future trials.

AB - Diabetes mellitus (DM) is a factor in the hematopoietic cell transplantation-comorbidity index. However, the impact of pre-transplant DM on morbidity and cause-specific non-relapse mortality (NRM) remains unclear. We performed a retrospective study with registry data that included a total of 7626 patients who underwent their first allogeneic hematopoietic SCT (HSCT) between 2007 and 2010. The median age was 44 years (range 0-88). Compared with patients without pre-transplant DM (non-DM group, n=7248), patients with pre-transplant DM (DM group, n=378) were older and were more likely to have high-risk disease, a reduced-intensity conditioning regimen and GVHD prophylaxis using tacrolimus. Multivariate analyses showed that pre-transplant DM was associated with increased risks of NRM (hazard ratio (HR)1.46, 95% confidence interval (CI) 1.21-1.76, P<0.01) and infection-related NRM (HR 2.08, 95% CI 1.58-2.73, P<0.01). The presence of pre-transplant DM was associated with an increased risk of overall mortality in a multivariate analysis (HR 1.55, 95% CI 1.35-1.78, P<0.01). In conclusion, pre-transplant DM was a risk factor for NRM, particularly infection-related mortality, after allogeneic HSCT. To improve the clinical outcome in patients with DM, the benefits of strict infection control and appropriate glycemic control should be explored in future trials.

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