Metabolic Alterations in Adult Long-Term Survivors after Hematopoietic Stem Cell Transplantation

Abstract

Introduction Hematopoietic stem cell transplantation (HSCT) is an option treatment for many types of hematologic diseases. However, HSCT leads to short- and long-term complications. Endocrinology complications are one those and even if is not the most common group of complications, their diagnoses and treatment can improve the quality of life in the patients. Objective To determine the cumulative incidence of metabolic alterations after 1st, 3rd and 5th year of HSCT in patients treated in a Colombian population. Methods We conducted an analytical and observational retrospective cohort of adult patients treated with autologous and allogeneic HSCT at a fourth level referral center in Colombia from 2009 to 2018. The evaluated metabolic complications were metabolic syndrome, hypertriglyceridemia, low HDL cholesterol, hypercholesterolemia, atherogenic dyslipidemia, overweight, obesity, prediabetes, diabetes mellitus, hypertension and hyperuricemia. Results A total of 217 patients were included, 53% were men and mean age was 46 years. 155 (71.4%) patients had autologous HSCT and 62 (28.6%) patients had allogeneic HSCT. Results for the 1st year were obtained from 171 patients, for 3rd year from 68 patients and 5th year from 20 patients. By type of transplant, the highest cumulative incidence in the group of patients treated with autologous HSCT was overweight (43%, 60.5% and 69%) followed by obesity (9.2%, 17.6% and 69%), while hypercholesterolemia presented the highest cumulative incidence (38.4%, 52% and 53.8%) followed by low HDL cholesterol (44%, 46% and 46%) in the group of patients treated with allogenic HSCT. The results of the evaluated alterations are shown in the attached figures. Conclusion Metabolic alterations are an important group of complications that needs to be taken into account even before and after the HSCT so an adequate prevention and treatment can be stablished, leading to decrease the risk of mortality in this group of patients. This study also suggests differences between the cumulative incidence of metabolic disease by type of transplant.