Harvanová Ľ, Petríková L, Bojtárová E, Žiaková B, Martišová M, Lábska V, Hrubiško M, Bátorová A, Mladosievičová B
Klin Onkol. 2022 Spring;35(2):132-138. doi: 10.48095/ccko2022132.
Allogeneic hematopoietic stem cell transplantation (HSCT) offers potentially curative therapy for numerous malignant and non-malignant diseases. The number of survivors and length of follow-up after successful HSCT is continually increasing. Hematopoietic stem cell transplantation can induce damage of various organs and tissues - from minimal potentially progressive subclinical changes to life-threatening conditions. The aim of this thesis was the evaluation of the prevalence of metabolic syndrome (MS) among survivors of allogeneic HSCT.
We analyzed 74 patients with a median age at transplant of 35 years, who had been followed for a median of 5 years (2-23 years) after allogeneic HSCT. MS was defined according to the National Cholesterol Education Programs Adult Treatment Panel III (NCEP ATP III) criteria and by the International Diabetes Federation (IDF) definition.
The prevalence of MS among HSCT recipients was 40.5% applying the NCEP ATP III definition and 39.2% the IDF, a 2.02-fold increase compared to the general Slovak population. MS was more common in men. The most common MS features were abdominal obesity, hypertriglyceridemia and hypertension. The lowest prevalence of MS was in the age group of 20-29 years; and the highest prevalence in the age group of 60-69 years. The 10-year cumulative incidence of MS was 32.5%. The most significant risk factor for MS was total body irradiation, positive family history and age > 40 years at HSCT. Seven patients (9.45%) developed cardiovascular complications. The median 10-year general cardiovascular risk scores for males and females were found to be 13.3% and 6.68%, respectively.
Detected increased prevalence of metabolic syndrome after allogeneic HSCT in patients surviving more than 2 years after this procedure may provide next stimulus to promote longer follow-up studies and to design of interventions to prevent late effects among survivors of serious hematologic diseases.
异基因造血干细胞移植（HSCT）为众多恶性和非恶性疾病提供了潜在的治愈性疗法。成功进行HSCT后的存活者数量及随访时间持续增加。造血干细胞移植可导致各种器官和组织受损——从轻微的潜在进展性亚临床变化到危及生命的状况。本论文的目的是评估异基因HSCT存活者中代谢综合征（MS）的患病率。
我们分析了74例移植时中位年龄为35岁的患者，他们在异基因HSCT后中位随访时间为5年（2至23年）。MS根据美国国家胆固醇教育计划成人治疗专家组第三次报告（NCEP ATP III）标准及国际糖尿病联盟（IDF）定义进行定义。
按照NCEP ATP III定义，HSCT受者中MS的患病率为40.5%，按照IDF定义为39.2%，相较于斯洛伐克普通人群增加了2.02倍。MS在男性中更为常见。MS最常见的特征是腹型肥胖、高甘油三酯血症和高血压。MS患病率最低的年龄组为20至29岁；最高的年龄组为60至69岁。MS的10年累积发病率为32.5%。MS最显著的危险因素是全身照射、家族史阳性以及HSCT时年龄>40岁。7例患者（9.45%）发生了心血管并发症。男性和女性的10年总体心血管风险评分中位数分别为13.3%和6.68%。
在异基因HSCT术后存活超过2年的患者中检测到代谢综合征患病率增加，这可能为推动更长时间的随访研究以及设计预防严重血液系统疾病存活者晚期效应的干预措施提供新的动力。
