Metabolic syndrome and cardiovascular disease after haematopoietic cell transplantation (HCT) in adults: an EBMT cross-sectional non-interventional study

D. M. Greenfield, N. Salooja, C. Peczynski, S. van der Werf, H. Schoemans, K. Hill, A. Cortelezzi, M. Lupo-Stangellini, Z. N. Özkurt, M. Arat, B. Metzner, P. Turlure, A. Rovo, G. Socié, M. Mohty, A. Nagler, N. Kröger, P. Dreger, M. Labopin, T. S. HanA. Tichelli, R. Duarte, G. Basak, J. A. Snowden

Research output: Contribution to journalArticlepeer-review

Abstract

Metabolic syndrome (MetS) is associated with cardiovascular disease in the general population and is also a potential cardiovascular risk factor in survivors of haematopoietic cell transplantation (HCT). We report an EBMT cross-sectional, multi-centre, non-interventional study of 453 adult HCT patients surviving a minimum of 2 years post-transplant attending routine follow-up HCT and/or late effects clinics in 9 centres. The overall prevalence of MetS was 37.5% rising to 53% in patients >50 years of age at follow-up. There were no differences in rates of MetS between autologous and allogeneic HCT survivors, nor any association with graft-versus-host disease (GvHD) or current immunosuppressant therapy. Notably, there was a significantly higher occurrence of cardiovascular events (CVE, defined as cerebrovascular accident, coronary heart disease or peripheral vascular disease) in those with MetS than in those without MetS (26.7% versus 9%, p < 0.001, OR 3.69, 95% CI 2.09–6.54, p < 0.001), and, as expected, MetS and CVE were age-related. Unexpectedly, CVE were associated with occurrence of second malignancy. Screening for and management of MetS should be integrated within routine HCT long-term follow-up care for both allogeneic and autologous HCT survivors. Further research is warranted, including randomised controlled trials of interventional strategies and mechanistic studies of cardiovascular risk in HCT survivors.

Original languageEnglish
JournalBone Marrow Transplantation
DOIs
Publication statusAccepted/In press - 2021

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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