Allogeneic Stem Cell Transplants associated with risk for Diabetes and Hypertension

An allogeneic stem cell transplant is a common treatment for some types of cancers, particularly leukemia and lymphoma. The process of an allogeneic stem cell transplant typically includes the use of high-dose chemotherapy or total body irradiation. These treatment approaches tend to kill more cancer cells than conventional doses; however, they are also associated with more severe side effects.
One common and potentially life-threatening side effect of these high-dose therapies is severely low levels of blood cells. Fortunately, hematopoeitic stem cells (immature blood cells) from a donor can be infused into the patient following high-dose therapy. These stem cells will then mature into functioning blood cells and can reduce serious complications associated with low levels of blood cells. Another approach to stem cell transplant is an autologous stem cell transplant, in which the patient’s own stem cells are collected prior therapy and reinfused following therapy.
Because patients who undergo allogeneic stem cell transplants can achieve long-term survival, researchers have become more focused on identifying long-term side effects that may be associated with this treatment approach.
Researchers affiliated with the Bone Marrow Transplant Survivor Study recently conducted a study involving 1,089 survivors who had undergone allogeneic or autologous stem cell transplants. The average follow-up was 8.6 years. The main findings of this study included the following:

• A 3.65-fold increase in diabetes was observed in allogeneic transplant recipients.
• A 2.06-fold increase in hypertension (high blood pressure) was observed in allogeneic transplant recipients.
• Total body irradiation was associated with an increased risk of diabetes.
• Autologous stem cell transplants were not associated with an increased risk of diabetes or hypertension.

These authors suggested that allogeneic transplant recipients may be at increased risk of future side effects including diabetes and hypertension. Patients who are recipients of allogeneic stem cell transplants may benefit from screening and monitoring for diabetes or hypertension so that these conditions may be identified and treated early.