Bergens Matthew A, Bokman John T, Johnson Ernaya J, Braun Matthew L, Li Yan, Bush Amy T, Hill Lauren, Van Opstal Jolien, Racioppi Alessandro, Fan Rebecca, Kaushik Sejal, Alyea Edwin, Chao Nelson, Choi Taewoong, Gasparetto Cristina, Horwitz Mitchell, Lopez Richard, Ramalingam Sendhilnathan, Sullivan Keith, Wischmeyer Paul, Sung Anthony D
School of Medicine, Duke University, Durham, NC, United States of America.
Division of Hematologic Malignancies and Cellular Therapy, Duke University, Durham, NC, United States of America.
PeerJ. 2025 Aug 8;13:e19822. doi: 10.7717/peerj.19822. eCollection 2025.
Recent studies have linked beta-blocker (BB) use in critical care settings with improved survival outcomes, potentially due to beta-adrenergic receptor (-AR) blockade and associated anti-inflammatory effects. Given the immune system's role in the development of graft--host disease (GVHD)-a major complication of allogeneic hematopoietic stem cell transplant (allo-HCT)-we conducted a single-center retrospective review to assess the impact of BB use on acute GVHD (aGVHD) and other survival outcomes in patients undergoing their first allo-HCT. We analyzed 10 years of data (January 2010 to May 2020), including 105 patients who received a BB for more than four days before and after HCT, and 669 control patients who did not receive a BB. Patients on BBs had a lower incidence of aGVHD (55.2% 65.8%, = 0.036); however, this difference was not statistically significant in multivariate analysis ( = 0.150). When stratified by BB mechanism, outcomes varied: non-selective BBs were associated with lower post-HCT weight ( = 0.034), and vasodilating BBs showed a borderline reduction in length of stay (LOS) ( = 0.054). While our findings confirm the pharmacological safety of BBs in this population, they do not support their routine use for modifying allo-HCT outcomes. Future prospective studies with larger cohorts are needed to further explore the role of BBs in peri-HCT management and to clarify their clinical implications and therapeutic potential.
近期研究表明，在重症监护环境中使用β受体阻滞剂（BB）可改善生存结局，这可能归因于β肾上腺素能受体（-AR）阻断及相关的抗炎作用。鉴于免疫系统在移植物抗宿主病（GVHD）——同种异体造血干细胞移植（allo-HCT）的主要并发症——发生过程中的作用，我们进行了一项单中心回顾性研究，以评估使用BB对接受首次allo-HCT患者的急性GVHD（aGVHD）及其他生存结局的影响。我们分析了10年的数据（2010年1月至2020年5月），包括105例在HCT前后接受BB治疗超过4天的患者，以及669例未接受BB治疗的对照患者。使用BB的患者aGVHD发生率较低（55.2%对65.8%，P = 0.036）；然而，在多变量分析中，这种差异无统计学意义（P = 0.150）。按BB作用机制分层时，结果有所不同：非选择性BB与HCT后体重较低相关（P = 0.034），血管舒张性BB显示住院时间（LOS）有临界性缩短（P = 0.054）。虽然我们的研究结果证实了BB在该人群中的药理学安全性，但并不支持将其常规用于改善allo-HCT结局。需要未来开展更大队列的前瞻性研究，以进一步探索BB在HCT围手术期管理中的作用，并阐明其临床意义和治疗潜力。
