ArticleInflammation2013
Severe hyperglycemia immediately after allogeneic hematopoietic stem-cell transplantation is predictive of acute graft-versus-host disease.
Article in Inflammation, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed, 35 citations in OpenAlex.
- Composite Metric of Glycemic Control Q-Score Is Elevated in Pediatric and Adolescent/Young Adult Hematopoietic Stem Cell Transplant Recipients.Diabetes technology & therapeutics · 2023Trial
- Feasibility and safety of using an automated decision support system for insulin therapy in the treatment of steroid-induced hyperglycemia in patients with acute graft-versus-host disease: A randomized trial.Journal of diabetes investigation · 2019Trial
- Pre-transplant diabetes mellitus is a risk factor for non-relapse mortality, especially infection-related mortality, after allogeneic hematopoietic SCT.Bone marrow transplantation · 2015Trial
- Steatotic Liver Disease in Allogeneic Hematopoietic Stem Cell Transplant Recipients: A Case Series and Literature Review.Hematology reports · 2026Article
- Hyperglycaemia as a predictor of morbidity and mortality in patients receiving an allogeneic haematopoietic stem cell transplantation.British journal of haematology · 2026Article
- 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.Bone marrow transplantation · 2024Article
- Chronic GvHD NIH Consensus Project Biology Task Force: evolving path to personalized treatment of chronic GvHD.Blood advances · 2023Article
- From support to therapy: rethinking the role of nutrition in acute graft-versus-host disease.Frontiers in immunology · 2023Review
- Review of Intravenous and Subcutaneous Electronic Glucose Management Systems for Inpatient Glycemic Control.Current diabetes reports · 2020Review
- Endocrine and Metabolic Disorders after Hematopoietic Cell TransplantationTurkish journal of haematology : official journal of Turkish Society of Haematology · 2020Article
- Biomarkers for Early Complications After Hematopoietic Stem Cell Transplantation.Clinics in laboratory medicine · 2019Review
- Malglycemia is associated with poor outcomes in pediatric and adolescent hematopoietic stem cell transplant patients.Blood advances · 2019Article
- Clinical impact of hyperglycemia on days 0-7 after allogeneic stem cell transplantation.Bone marrow transplantation · 2017Article
- Measurement of Hyperglycemia and Impact on Health Outcomes in People With Cancer: Challenges and Opportunities.Oncology nursing forum · 2017Review
- Prevalence, predictors, and outcomes of steroid-induced hyperglycemia in hospitalized patients with hematologic malignancies.Endocrine · 2017Article
- How do I manage hyperglycemia/post-transplant diabetes mellitus after allogeneic HSCT.Bone marrow transplantation · 2016Review
- Blood glucose control using a computer-guided glucose management system in allogeneic hematopoietic cell transplant recipients.Bone marrow transplantation · 2016Article
- Dynamic change of glycemic status during the early phase after allogeneic hematopoietic stem cell transplantation.Bone marrow transplantation · 2015Article
- Management of the hospitalized transplant patient.Current diabetes reports · 2015Review
- Hyperglycemia in patients with hematologic malignancies.Current diabetes reports · 2015Review
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
Stress hyperglycemia and acute graft-versus-host disease (GVHD), the major early complication of hematopoietic stem cell transplantation (HSCT), are both associated with excessive release of inflammatory cytokines. We investigated whether new-onset hyperglycemia immediately after HSCT predicts acute GVHD. We studied nondiabetic adult recipients of human leukocyte antigen-matched HSCT (peripheral blood stem cells) for acute leukemia. Using mean morning serum glucose on Days 1-10, we classified hyperglycemia as: mild (6.11-8.33 mmol/L), moderate (8.34-9.98), and severe (minimum of 9.99). Subjects who were GVHD-free on Day 10 were followed during Days 11-100 for grades II-IV acute GVHD or competing event. Evaluation utilized cumulative incidence-based proportional hazards regression. Subjects (n = 328) were age 18-74, median of 49 years. Per body mass index (BMI)--25.0 % were obese (BMI, 30-48), 33.8 % overweight (25 to <30), 30.8 % normal weight (21 to <25), and 10.4 % lean (18 to <21). Mild, moderate, or severe hyperglycemia occurred during Days 1-10 in 50.0, 21.3, and 16.8 % of subjects, respectively. Cumulative incidence on Day 100 was 44.8 (±2.8) % acute GVHD and 7.9 (±1.5) % competing event. Among normal-to-overweight subjects (n = 212), severe hyperglycemia developed in 14.2 % (n = 30) and more than doubled the risk of acute GVHD (hazards ratio, 2.71; 95 % CI, 1.58-4.65--adjusted for donor/recipient characteristics, prophylactic regimen, and mucositis). In contrast, among obese subjects (n = 82), severe hyperglycemia developed in 30.5 % (n = 25) but did not significantly affect risk of GVHD. (No lean subjects (n = 34) developed severe hyperglycemia.) Hyperglycemia that was less than severe had an effect indistinguishable from normoglycemia. In nondiabetic patients, severe hyperglycemia immediately after allogeneic HSCT indicates increased likelihood of acute GVHD. This association is absent in obese patients, who may be primed by obesity-induced inflammation to develop severe hyperglycemia even without experiencing the cytokine storm that is essential to GVHD pathogenesis.
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