Retrospective study of prognostic significance of hyperglycemia in patients receiving allogeneic hematopoietic stem cell transplantation

Allogeneic hematopoietic stem cell transplantation (alloHSCT) is an effective treatment for patients with hematologic malignancies; however, post-transplant complications, including infections and acute graft-versus-host disease (aGVHD), remain significant issues. A retrospective study at University Medical Center Groningen (The Netherlands) evaluated the prognostic significance of hyperglycemia (glucose level exceeding 10 mmol/L) for post-transplant outcomes. A total of 575 patients undergoing alloHSCT between 2018 and 2024 were included. The median age was 61 years (IQR 52-68) and 64% were male. During hospitalization, 26.6% of patients experienced at least on episode of hyperglycemia. Hyperglycemia was associated with significantly higher mortality risk (HR 5.07; 95% CI 3.02-8.54). Adjusted for possible confounders, hyperglycemia remained a risk factor for significantly reduced 100-day overall survival (HR 2.36; 95% CI 1.29-4.33). It was also linked to an increased risk of grade ≥ 3 aGVHD and infections. Importantly, hyperglycemia occurring within 30 days prior to transplantation already predicted poorer survival. The authors conclude that hyperglycemia is predictive for adverse outcomes in patients undergoing alloHSCT.