The Effect of Glucose Levels Prior to Hematopoietic Cell Transplantation on Post-Transplant Complications and Health Resource Utilization
-
Amir Steinberg
,
Janet H. Van Cleave
,
Anish B. Parikh
,
Erin Moshier
,
Meng Ru
,
Molly Lawson
,
Douglas Marks
,
Antoinette Montelibano
,
Amanda Philpott
,
Kourtney Garner
,
Marilyn J. Hammer
Abstract
Background: Abnormal blood glucose (BG) levels during hematopoietic cell transplantation (HCT) are associated with increased infections, delayed engraftment, and prolonged hospitalization, though little is known about these associations.
Materials and Methods: We retrospectively evaluated mean BG levels in the week prior to HCT and subsequent outcomes for 852 HCTs at our hospital from 1/2009 – 12/2013 pertaining to 745 patients. Outcomes included infections (pneumonia, C. difficile, positive cultures, administration of antimicrobials, or neutropenic fever), time-to-engraftment (TTE), and quality indicators (30- and 90-day readmission rates [RR] and median length-of-stay [LOS]).
Results: We retrospectively evaluated mean BG levels in the week prior to HCT and subsequent outcomes for 852 HCTs at our hospital from 1/2009 – 12/2013 pertaining to 745 patients. Outcomes included infections (pneumonia, C. difficile, positive cultures, administration of antimicrobials, or neutropenic fever), time-to-engraftment (TTE), and quality indicators (30- and 90-day readmission rates [RR] and median length-of-stay [LOS]).|
Conclusion: Pre-HCT BG trends may be a prognostic biomarker for adverse outcomes, and thus can help improve quality of care for HCT patients.
1. Berwick DM, Nolan TW, Whittington J. The Triple Aim: Care, Health, and Cost.Health Aff (Millwood). 2008; 27(3):759-69.
2. Mariotto AB, Yabroff KR, Shao Y, et al. Projections of the cost of cancer care in the United States: 2010-2020. J Natl Cancer Inst. 2011; 103(2):117-128.
3. Hammer MJ, Casper C, Gooley TA, et al. The contribution of malglycemia to mortality among allogeneic hematopoietic cell transplant recipients. Biol Blood Marrow Transplant. 2009; 15(3):344-51
4. Barone BB, Yeh HC, Snyder CF, et al. Long-term all-cause mortality in cancer patients with preexisting diabetes mellitus: a systematic review and meta-analysis. JAMA. 2008; 300(23):2754-64.
5. National Diabetes Statistics, 2017. National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Health Statistics September 2017. https://www.niddk.nih.gov/health-information/health-statistics/diabetes-statistics. Accessed March 16, 2018.
6. Giovannucci E, Harlan DM, Archer MC, et al. Diabetes and cancer: a consensus report. Diabetes Care. 2010; 33(7):1674-85.
7. Smiley D, Umpierrez GE. Management of hyperglycemia in hospitalized patients. Ann N Y Acad Sci.2010; 1212:1-11.
8. Yu T, Jhun BS, Yoon Y. High-glucose stimulation increases reactive oxygen species production through the calcium and mitogen-activated protein kinase-mediated activation of mitochondrial fission.Antioxid Redox Signal. 2011; 14(3):425-37.
9. Mantovani A, Allavena P, Sica A, et al. Cancer-related inflammation. Nature; 2008. 454(7203):436-44.
10. Pickup JC. Inflammation and activated innate immunity in the pathogenesis of type 2 diabetes. Diabetes Care.2004; 27(3):813-23.
11. Esposito K, Nappo F, Marfella R, et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation. 2002; 106(16):2067-72.
12. Gale SC, Sicoutris C, Reilly PM, et al. Poor glycemic control is associated with increased mortality in critically ill trauma patients.Am Surg. 2007; 73(5):454-60.
13. Germenis AE, Karanikas V. Immunoepigenetics: the unseen side of cancer immunoediting.Immunol Cell Biol. 2007; 85(1):55-9.
14. Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes. 2005; 54(6):1615-25.
15. Kramer PA, Ravi S, Chacko B, et al. A review of the mitochondrial and glycolytic metabolism in human platelets and leukocytes: Implications for their use as bioenergetic biomarkers. Redox Biol. 2014; 2:206-10.
16. Butler SO, Btaiche IF, Alaniz C. Relationship between hyperglycemia and infection in critically ill patients. Pharmacotherapy. 2005; 25(7):963-76.
17. Stookey JD, Pieper CF, Cohen HJ. Hypertonic hyperglycemia progresses to diabetes faster than normotonic hyperglycemia. Eur J Epidemiol. 2004; 19(10):935-44.
18. Roumen C, Blaak EE, Corpeleijn E. Lifestyle intervention for prevention of diabetes: determinants of success for future implementation.Nutr Rev. 2009; 67(3):132-46.
19. Jenkins DJ, Kendall CW, Augustin LS, et al. Glycemic index: overview of implications in health and disease. Am J Clin Nutr. 2002; 76(1):266S-73S.
20. Martin-Salces M, de Paz R, Canales MA, et al. Nutritional recommendations in hematopoietic stem cell transplantation. Nutrition. 2008; 24(7-8):769-75.
21. Katz A. Modulation of glucose transport in skeletal muscle by reactive oxygen species. J Appl Physiol (1985). 2007; 102(4):1671-6.
22. Moien-Afshari F, Ghosh S, Khazaei M, et al. Exercise restores endothelial function independently of weight loss or hyperglycaemic status in db/db mice. Diabetologia. 2008; 51(7):1327-37.
23. Godbout JP, Glaser R. Stress-induced immune dysregulation: implications for wound healing, infectious disease and cancer. J Neuroimmune Pharmacol. 2006; 1(4):421-7.
24. Mazali FC, Lalli CA, Alves-Filho G, et al. Posttransplant diabetes mellitus: incidence and risk factors.Transplant Proc. 2008; 40(3):764-6.
25. Ramos-Cebrián M, Torregrosa JV, Gutierrez-Dalmau A, et al. Conversion from tacrolimus to cyclosporine could improve control of posttransplant diabetes mellitus after renal transplantation. Transplant Proc. 2007; 39(7):2251-3.
26. Willi SM, Kennedy A, Wallace P, et al. Troglitazone antagonizes metabolic effects of glucocorticoids in humans: effects on glucose tolerance, insulin sensitivity, suppression of free fatty acids, and leptin. Diabetes. 2002; 51(10):2895-902.
27. Turina M, Christ-Crain M, Polk Jr HC. Diabetes and hyperglycemia: strict glycemic control. Crit Care Med. 2006; 34(9 Suppl):S291-300.
28. Fuji S, Kim SW, Mori S, et al. Hyperglycemia during the neutropenic period is associated with a poor outcome in patients undergoing myeloablative allogeneic hematopoietic stem cell transplantation. Transplantation. 2007; 84(7):814-20.
29. Derr RL, Hsiao VC, Saudek CD. Antecedent hyperglycemia is associated with an increased risk of neutropenic infections during bone marrow transplantation. Diabetes Care. 2008; 31(10):1972-7.
30. Orlandi A, Chavakis E, Seeger F, et al. Long-term diabetes impairs repopulation of hematopoietic progenitor cells and dysregulates the cytokine expression in the bone marrow microenvironment in mice. Basic Res Cardiol. 2010;105(6):703-12.
31. Sheean PM, Braunschweig C, Rich E. The incidence of hyperglycemia in hematopoietic stem cell transplant recipients receiving total parenteral nutrition: a pilot study. J Am Diet Assoc. 2004; 104(9):1352-60.
32. Nagin DS, Odgers CL. Group-based trajectory modeling in clinical research. Annu Rev Clin Psychol. 2010; 6: 109-38.
33. Andersen RM. Revisiting the behavioral model and access to medical care: Does it matter?J Health Soc Behav. 1995; 36(1):1-10.
34. Jencks SF, Williams, MV, Coleman EA. Rehospitalizations among patients in the Medicare Fee-for-Service program.N Engl J Med. 2009; 360(14):1418-28.
35. Jones BL, Nagin DS, Roeder K. A SAS procedure based on mixture models for estimating development trajectories.SOCIOL METHOD RES. 2001; 29(3):374–393.
2. Mariotto AB, Yabroff KR, Shao Y, et al. Projections of the cost of cancer care in the United States: 2010-2020. J Natl Cancer Inst. 2011; 103(2):117-128.
3. Hammer MJ, Casper C, Gooley TA, et al. The contribution of malglycemia to mortality among allogeneic hematopoietic cell transplant recipients. Biol Blood Marrow Transplant. 2009; 15(3):344-51
4. Barone BB, Yeh HC, Snyder CF, et al. Long-term all-cause mortality in cancer patients with preexisting diabetes mellitus: a systematic review and meta-analysis. JAMA. 2008; 300(23):2754-64.
5. National Diabetes Statistics, 2017. National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Health Statistics September 2017. https://www.niddk.nih.gov/health-information/health-statistics/diabetes-statistics. Accessed March 16, 2018.
6. Giovannucci E, Harlan DM, Archer MC, et al. Diabetes and cancer: a consensus report. Diabetes Care. 2010; 33(7):1674-85.
7. Smiley D, Umpierrez GE. Management of hyperglycemia in hospitalized patients. Ann N Y Acad Sci.2010; 1212:1-11.
8. Yu T, Jhun BS, Yoon Y. High-glucose stimulation increases reactive oxygen species production through the calcium and mitogen-activated protein kinase-mediated activation of mitochondrial fission.Antioxid Redox Signal. 2011; 14(3):425-37.
9. Mantovani A, Allavena P, Sica A, et al. Cancer-related inflammation. Nature; 2008. 454(7203):436-44.
10. Pickup JC. Inflammation and activated innate immunity in the pathogenesis of type 2 diabetes. Diabetes Care.2004; 27(3):813-23.
11. Esposito K, Nappo F, Marfella R, et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation. 2002; 106(16):2067-72.
12. Gale SC, Sicoutris C, Reilly PM, et al. Poor glycemic control is associated with increased mortality in critically ill trauma patients.Am Surg. 2007; 73(5):454-60.
13. Germenis AE, Karanikas V. Immunoepigenetics: the unseen side of cancer immunoediting.Immunol Cell Biol. 2007; 85(1):55-9.
14. Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes. 2005; 54(6):1615-25.
15. Kramer PA, Ravi S, Chacko B, et al. A review of the mitochondrial and glycolytic metabolism in human platelets and leukocytes: Implications for their use as bioenergetic biomarkers. Redox Biol. 2014; 2:206-10.
16. Butler SO, Btaiche IF, Alaniz C. Relationship between hyperglycemia and infection in critically ill patients. Pharmacotherapy. 2005; 25(7):963-76.
17. Stookey JD, Pieper CF, Cohen HJ. Hypertonic hyperglycemia progresses to diabetes faster than normotonic hyperglycemia. Eur J Epidemiol. 2004; 19(10):935-44.
18. Roumen C, Blaak EE, Corpeleijn E. Lifestyle intervention for prevention of diabetes: determinants of success for future implementation.Nutr Rev. 2009; 67(3):132-46.
19. Jenkins DJ, Kendall CW, Augustin LS, et al. Glycemic index: overview of implications in health and disease. Am J Clin Nutr. 2002; 76(1):266S-73S.
20. Martin-Salces M, de Paz R, Canales MA, et al. Nutritional recommendations in hematopoietic stem cell transplantation. Nutrition. 2008; 24(7-8):769-75.
21. Katz A. Modulation of glucose transport in skeletal muscle by reactive oxygen species. J Appl Physiol (1985). 2007; 102(4):1671-6.
22. Moien-Afshari F, Ghosh S, Khazaei M, et al. Exercise restores endothelial function independently of weight loss or hyperglycaemic status in db/db mice. Diabetologia. 2008; 51(7):1327-37.
23. Godbout JP, Glaser R. Stress-induced immune dysregulation: implications for wound healing, infectious disease and cancer. J Neuroimmune Pharmacol. 2006; 1(4):421-7.
24. Mazali FC, Lalli CA, Alves-Filho G, et al. Posttransplant diabetes mellitus: incidence and risk factors.Transplant Proc. 2008; 40(3):764-6.
25. Ramos-Cebrián M, Torregrosa JV, Gutierrez-Dalmau A, et al. Conversion from tacrolimus to cyclosporine could improve control of posttransplant diabetes mellitus after renal transplantation. Transplant Proc. 2007; 39(7):2251-3.
26. Willi SM, Kennedy A, Wallace P, et al. Troglitazone antagonizes metabolic effects of glucocorticoids in humans: effects on glucose tolerance, insulin sensitivity, suppression of free fatty acids, and leptin. Diabetes. 2002; 51(10):2895-902.
27. Turina M, Christ-Crain M, Polk Jr HC. Diabetes and hyperglycemia: strict glycemic control. Crit Care Med. 2006; 34(9 Suppl):S291-300.
28. Fuji S, Kim SW, Mori S, et al. Hyperglycemia during the neutropenic period is associated with a poor outcome in patients undergoing myeloablative allogeneic hematopoietic stem cell transplantation. Transplantation. 2007; 84(7):814-20.
29. Derr RL, Hsiao VC, Saudek CD. Antecedent hyperglycemia is associated with an increased risk of neutropenic infections during bone marrow transplantation. Diabetes Care. 2008; 31(10):1972-7.
30. Orlandi A, Chavakis E, Seeger F, et al. Long-term diabetes impairs repopulation of hematopoietic progenitor cells and dysregulates the cytokine expression in the bone marrow microenvironment in mice. Basic Res Cardiol. 2010;105(6):703-12.
31. Sheean PM, Braunschweig C, Rich E. The incidence of hyperglycemia in hematopoietic stem cell transplant recipients receiving total parenteral nutrition: a pilot study. J Am Diet Assoc. 2004; 104(9):1352-60.
32. Nagin DS, Odgers CL. Group-based trajectory modeling in clinical research. Annu Rev Clin Psychol. 2010; 6: 109-38.
33. Andersen RM. Revisiting the behavioral model and access to medical care: Does it matter?J Health Soc Behav. 1995; 36(1):1-10.
34. Jencks SF, Williams, MV, Coleman EA. Rehospitalizations among patients in the Medicare Fee-for-Service program.N Engl J Med. 2009; 360(14):1418-28.
35. Jones BL, Nagin DS, Roeder K. A SAS procedure based on mixture models for estimating development trajectories.SOCIOL METHOD RES. 2001; 29(3):374–393.
| Files | ||
| Issue | Vol 13, No 3 (2019) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijhoscr.v13i3.1270 | |
| Keywords | ||
| Glucose; Hyperglycemia; Patient readmission; Bone marrow transplant; Infection; Health resource utilization | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Steinberg A, Van Cleave J, Parikh A, Moshier E, Ru M, Lawson M, Marks D, Montelibano A, Philpott A, Garner K, Hammer M. The Effect of Glucose Levels Prior to Hematopoietic Cell Transplantation on Post-Transplant Complications and Health Resource Utilization. Int J Hematol Oncol Stem Cell Res. 2019;13(3):122-131.
