Diabetes, hypertension, and cardiovascular events in survivors of hematopoietic cell transplantation: A report from the bone marrow transplantation survivor study Journal Article


Authors: Baker, K. S.; Ness, K. K.; Steinberger, J.; Carter, A.; Francisco, L.; Burns, L. J.; Sklar, C.; Forman, S.; Weisdorf, D.; Gurney, J. G.; Bhatia, S.
Article Title: Diabetes, hypertension, and cardiovascular events in survivors of hematopoietic cell transplantation: A report from the bone marrow transplantation survivor study
Abstract: We ascertained the prevalence of self-reported late occurrence of diabetes, hypertension, and cardiovascular (CV) disease in 1089 hematopoietic cell transplantation (HCT) survivors who underwent HCT between 1974 and 1998, survived at least 2 years, and were not currently taking immunosuppressant agents and compared them with 383 sibling controls. All subjects completed a 255-item health questionnaire. The mean age at survey completion was 39.3 years for survivors and 38.6 years for siblings; mean follow-up was 8.6 years. Adjusting for age, sex, race, and body mass index (BMI), survivors of allogeneic HCT were 3.65 times (95% confidence interval [CI], 1.82-7.32) more likely to report diabetes than siblings and 2.06 times (95% CI, 1.39-3.04) more likely to report hypertension compared with siblings but did not report other CV outcomes with any greater frequency. Recipients of autologous HCTs were no more likely than siblings to report any of the outcomes studied. Allogeneic HCT survivors were also more likely to develop hypertension (odds ratio [OR] = 2.31; 95% CI, 1.45-3.67) than autologous recipients. Total body irradiation (TBI) exposure was associated with an increased risk of diabetes (OR = 3.42; 95% CI, 1.55-7.52). Thus, HCT survivors have a higher age- and BMI-adjusted risk of diabetes and hypertension, potentially leading to a higher than expected risk of CV events with age. © 2007 by The American Society of Hematology.
Keywords: adult; controlled study; transplantation, homologous; major clinical study; case-control studies; hypertension; comparative study; outcome assessment; follow up; follow-up studies; prevalence; health survey; allogenic bone marrow transplantation; hematopoietic stem cell transplantation; radiation exposure; survivor; risk assessment; siblings; survivors; confidence interval; questionnaire; body mass; hematologic malignancy; whole body radiation; data collection; cardiovascular disease; cardiovascular diseases; diabetes mellitus; allogeneic hematopoietic stem cell transplantation; age distribution; sibling; transplantation, autologous; graft recipient; autologous hematopoietic stem cell transplantation; whole-body irradiation; frequency analysis
Journal Title: Blood
Volume: 109
Issue: 4
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2007-02-15
Start Page: 1765
End Page: 1772
Language: English
DOI: 10.1182/blood-2006-05-022335
PUBMED: 17047152
PROVIDER: scopus
PMCID: PMC1794046
DOI/URL:
Notes: --- - "Cited By (since 1996): 59" - "Export Date: 17 November 2011" - "CODEN: BLOOA" - "Source: Scopus"
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  1. Charles A Sklar
    312 Sklar