Metabolic Syndrome Occurs within the First Year after Hematopoietic Cell Transplant

Background: Improved survival after allogeneic hematopoietic cell transplantation (allo-HCT), enables us to learn more about potential late complications after HCT, including metabolic syndrome (MS).  This is the first study investigating the prevalence or development of metabolic syndrome within the first year post-HCT in adult myeloablative transplant recipients.

Methods:  This was a retrospective study that evaluated the prevalence of and risk factors associated with metabolic syndrome early post-HCT in 785 human subjects. As data was collected retrospectively, it required substitution for certain metabolic syndrome parameters. Thus, we evaluated metabolic characteristics using available objective data referred to as modified metabolic syndrome (MMS). 

Results:  We demonstrated that the incidence of MMS was 34% pre-HCT, 48% at day 80 post-HCT, and 40% at one year post-HCT. MMS at day 80 post-HCT was predictive of having MMS at one year post-HCT. Hypertriglyceridemia was the predominant qualifying criteria for MMS, present in 91-93% of patients. Age (>50) and TBI-based conditioning regimen were significantly associated with developing MMS at day 80 post-HCT (p=0.0006 and p=0.005, respectively). Both TBI and age remain highly significant in multivariate analysis (p=0.0009 for TBI and p=0.0001 for age) at day 80 post-HCT. TBI was also predictive of MMS at 1 year post-HCT (p=0.01). 

Conclusion: Although we substitute a number of the metabolic syndrome factors based on data availability, we believe that the substituted factors used in this study are still clinically relevant as risk factors for coronary heart disease. These results support the need for nutrition and lifestyle intervention in order to prevent and treat metabolic abnormalities among patients who survive the acute transplant period.