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造血细胞移植后的代谢综合征与心血管疾病:CIBMTR和EBMT的筛查及预防实践建议

Metabolic Syndrome and Cardiovascular Disease after Hematopoietic Cell Transplantation: Screening and Preventive Practice Recommendations from the CIBMTR and EBMT.

作者信息

DeFilipp Zachariah, Duarte Rafael F, Snowden John A, Majhail Navneet S, Greenfield Diana M, Miranda José López, Arat Mutlu, Baker K Scott, Burns Linda J, Duncan Christine N, Gilleece Maria, Hale Gregory A, Hamadani Mehdi, Hamilton Betty K, Hogan William J, Hsu Jack W, Inamoto Yoshihiro, Kamble Rammurti T, Lupo-Stanghellini Maria Teresa, Malone Adriana K, McCarthy Philip, Mohty Mohamad, Norkin Maxim, Paplham Pamela, Ramanathan Muthalagu, Richart John M, Salooja Nina, Schouten Harry C, Schoemans Helene, Seber Adriana, Steinberg Amir, Wirk Baldeep M, Wood William A, Battiwalla Minoo, Flowers Mary E D, Savani Bipin N, Shaw Bronwen E

机构信息

Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia.

Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.

出版信息

Biol Blood Marrow Transplant. 2016 Aug;22(8):1493-1503. doi: 10.1016/j.bbmt.2016.05.007. Epub 2016 May 14.

Abstract

Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors that increases the risk of cardiovascular disease, diabetes mellitus, and all-cause mortality. Long-term survivors of hematopoietic cell transplantation (HCT) have a substantial risk of developing MetS and cardiovascular disease, with an estimated prevalence of MetS of 31% to 49% among HCT recipients. Although MetS has not yet been proven to impact cardiovascular risk after HCT, an understanding of the incidence and risk factors for MetS in HCT recipients can provide the foundation to evaluate screening guidelines and develop interventions that may mitigate cardiovascular-related mortality. A working group was established through the Center for International Blood and Marrow Transplant Research and the European Group for Blood and Marrow Transplantation with the goal to review literature and recommend practices appropriate to HCT recipients. Here we deliver consensus recommendations to help clinicians provide screening and preventive care for MetS and cardiovascular disease among HCT recipients. All HCT survivors should be advised of the risks of MetS and encouraged to undergo recommended screening based on their predisposition and ongoing risk factors.

摘要

代谢综合征(MetS)是一组心血管危险因素,会增加患心血管疾病、糖尿病和全因死亡率的风险。造血细胞移植(HCT)的长期存活者有患MetS和心血管疾病的重大风险,估计HCT受者中MetS的患病率为31%至49%。尽管尚未证明MetS会影响HCT后的心血管风险,但了解HCT受者中MetS的发病率和危险因素可为评估筛查指南以及制定可能降低心血管相关死亡率的干预措施提供基础。通过国际血液和骨髓移植研究中心以及欧洲血液和骨髓移植组成立了一个工作组,目标是回顾文献并推荐适用于HCT受者的做法。在此,我们提供共识性建议,以帮助临床医生为HCT受者中的MetS和心血管疾病提供筛查和预防性护理。应告知所有HCT幸存者MetS的风险,并鼓励他们根据自身易感性和持续存在的危险因素接受推荐的筛查。

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