Hoffmeister Paul A, Storer Barry E, Sanders Jean E
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
J Pediatr Hematol Oncol. 2004 Feb;26(2):81-90. doi: 10.1097/00043426-200402000-00003.
To identify risk factors associated with the development of diabetes mellitus and to describe the prevalence of diabetes in pediatric hematopoietic cell transplant (HCT) survivors. The follow-up records of 748 patients who survived for at least 2 years after pediatric HCT were retrospectively reviewed for diagnosis of diabetes. Risk factors for type 2 diabetes were analyzed using multivariate statistics. Among 748 patients with a median of 11 years of follow-up, 38 developed diabetes after HCT. Four patients (three leukemia and one neuroblastoma) developed type 1 diabetes 8 to 14 years after HCT, at between 10 and 19 years of age. Thirty-four patients (32 leukemia and 2 aplastic anemia) developed type 2 diabetes 1 to 24 years after HCT, at between 11 and 41 years of age. Of the 34 patients with type 2 diabetes, 23 were non-Hispanic white, 3 had experienced asparaginase toxicity (hyperglycemia and/or pancreatitis), and 26 had a family history of diabetes. Risk factors associated with type 2 diabetes were diagnosis of acute or chronic leukemia, race/ethnicity other than non-Hispanic white, family history of diabetes, and asparaginase toxicity. The prevalence of type 1 diabetes among all surviving patients was 0.52%, or three times higher than the general U.S. population. The prevalence of type 2 diabetes was 9% among leukemia survivors and 2% among aplastic anemia survivors, both higher than expected. Pediatric HCT survivors are more likely to develop diabetes than the general population.
确定与糖尿病发生相关的危险因素，并描述小儿造血干细胞移植（HCT）幸存者中糖尿病的患病率。对748例小儿HCT后存活至少2年的患者的随访记录进行回顾性分析，以诊断糖尿病。使用多变量统计分析2型糖尿病的危险因素。在748例中位随访时间为11年的患者中，38例在HCT后发生糖尿病。4例患者（3例白血病和1例神经母细胞瘤）在HCT后8至14年、10至19岁时发生1型糖尿病。34例患者（32例白血病和2例再生障碍性贫血）在HCT后1至24年、11至41岁时发生2型糖尿病。在34例2型糖尿病患者中，23例为非西班牙裔白人，3例曾发生天冬酰胺酶毒性（高血糖和/或胰腺炎），26例有糖尿病家族史。与2型糖尿病相关的危险因素为急性或慢性白血病诊断、非西班牙裔白人以外的种族/族裔、糖尿病家族史和天冬酰胺酶毒性。所有存活患者中1型糖尿病的患病率为0.52%，比美国普通人群高3倍。白血病幸存者中2型糖尿病的患病率为9%，再生障碍性贫血幸存者中为2%，均高于预期。小儿HCT幸存者比普通人群更易发生糖尿病。
