ASSOCIATION OF HYPERGLYCEMIA WITH PROLONGED HOSPITAL STAY BUT NO EFFECT ON ENGRAFTMENT AFTER AUTOLOGOUS HEMATOPOIETIC STEM CELL TRANSPLANTATION

作者：Karnchanasorn Rudruidee; Malamug Lou Rose; Jin Rami; Karanes Chatchada; Chiu Ken C^*

来源：Endocrine Practice, 2012, 18(4): 508-518.

DOI：10.4158/EP11307.OR

Objective: To determine the effect of hyperglycemia, which is associated with poor outcome of various diseases, on the outcome of hematopoietic stem cell transplantation (HSCT).
Methods: We examined the influence of blood glucose concentration (BGC) on the outcome of autologous HSCT. Patients had at least one BGC determination every morning during their hospitalization. The relationships of BGC with time to engraftment and length of hospital stay (LOHS) after transplantation were analyzed.
Results: The correlation of LOHS after transplantation was found only with posttransplant averaged BGC (P = .0004) in patients without diabetes (N = 240) but not with pretransplant. averaged BGC or BGC on the morning of transplantation. The correlation remained significant after adjustment for sex, age, and body mass index (P = .0002) and for use of glucocorticoids and total parenteral nutrition (P = .04). No correlation was observed, however, between BGC and timing of engraftment. We further analyzed the entire data set of subjects (N = 335) on the basis of posttransplant morning BGC and divided these patients into 2 groups: those with BGC <150 mg/dL and those with BGC >= 150 mg/dL. No difference in engraftment time was noted between these 2 groups, but a correlation was observed with LOHS after transplantation (14 +/- 4 days versus 17 +/- 6 days, respectively; P<.0001).
Conclusion: We observed that posttransplant averaged BGC significantly correlated with LOHS after transplantation. BGC, however, had no effect on the timing of engraftment. Thus, our results suggest that better glycemic control could potentially shorten hospital stay after HSCT. (Endocr Pract. 2012;18:508-518)

• 出版日期2012-8