Metabolic disease incidence after allogeneic stem cell transplantation: A Korean, nationwide, case-control study

Context and Objectives

There have been no large-scale reports elucidating the relative risks of developing metabolic diseases in adult allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients compared to the general population.

Participants and Methods

We conducted a population-based case-control study and analyzed data of 8,230 adult allo-HSCT recipients and 32,920 healthy individuals matched for age, sex, and the index date in a 1:4 ratio, using a nationwide database of the Korean National Health Insurance Service. Thereafter, we established four sub-studies to investigate the relative risks of metabolic disease development following allo-HSCT: hypertension (cohort A study), diabetes (cohort B study), dyslipidemia (cohort C study), and CVA (cohort D study).

Results

The 10-year cumulative incidence of metabolic disease in each experimental cohort was significantly higher than that in the control cohort (overall p-value <0.001 for all): cohort A study, 17.6% vs. 11.8%; cohort B study, 23.5% vs. 14.4%; cohort C study for dyslipidemia, 44.5% vs. 32.1%; and cohort D study for CVA, 4.2% vs. 3.2%. In comparison to the incidence of metabolic diseases in the general population, allo-HSCT recipients presented adjusted hazard ratios of 1.58 for hypertension, 2.06 for diabetes, 1.62 for dyslipidemia, and 1.45 for CVA.

Conclusions

Recipients of allo-HSCT need to be rigorously monitored for the development of metabolic diseases, including hypertension, diabetes, dyslipidemia, and CVA, based on an enhanced lifelong healthcare policy including a robust screening program compared to the general population.