| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 5524227 | Biology of Blood and Marrow Transplantation | 2017 | 4 Pages |
â¢Post-transplantation diabetes mellitus occurs commonly after allogeneic transplantationâ¢Post-transplantation diabetes mellitus and acute graft-versus-host disease are affected by the IL-33/suppression of tumorigenicity 2 axisâ¢Elevated engraftment soluble suppression of tumorigenicity 2 predicts increased post-transplantation diabetes mellitusâ¢Elevated engraftment soluble suppression of tumorigenicity 2 predicts increased nonrelapse mortality risk
New-onset post-transplantation diabetes mellitus (PTDM) occurs commonly after allogeneic hematopoietic cell transplantation (HCT) and is associated with inferior survival. We hypothesize that PTDM and nonrelapse mortality (NRM) are related to IL-33/suppression of tumorigenicity 2 (ST2) signaling and that soluble ST2 (sST2) levels will predict PTDM diagnosis. sST2 was measured at engraftment and day +30 in 36 euglycemic HCT recipients followed prospectively for PTDM (cohort 1). Results were confirmed in a validation cohort of 26 patients without pre-existing diabetes analyzed retrospectively for PTDM (cohort 2). Twelve patients with established diabetes before HCT were analyzed in cohort 3. When compared with recipients without PTDM, patients developing PTDM (nâ=â24) from cohort 1 had elevated sST2 levels at engraftment (Pâ=â.02) and at day +30 (Pâ<â.01). Cohort 2 confirmed this finding at engraftment (Pâ=â.01). Cohort 3 patients with pretransplantation diabetes had higher sST2 at engraftment than patients maintaining euglycemia after HCT from cohort 2 (Pâ=â.03). Multivariate analysis of cohorts 1 and 2 showed high engraftment sST2 predicted increased PTDM and NRM risk, independent of conditioning and grades 3 to 4 acute graft-versus-host-disease. sST2 was elevated in PTDM, indicating a relationship between glucose homeostasis and the IL-33/ST2 axis after transplantation. Correction of metabolic complications may decrease sST2 and improve NRM.
