Evidence-Based Screening and Prevention Recommendations for Post-Transplant MetS

Long-term hematopoietic cell transplant (HCT) recipients have a substantial risk (prevalence rates of 31-49% have been reported in the literature) of developing metabolic syndrome (MetS) and therefore a concurrent higher risk of cardiovascular disease, diabetes mellitus and all-cause mortality. Two international transplant organizations have therefore recommended that all HCT survivors be advised of the risks of MetS and encouraged to undergo recommended screening based on their predisposition and ongoing risk factors.

The consensus report developed by transplant experts from CIBMTR (Center for International Blood and Marrow Transplant Research) and EBMT (European Society for Blood and Marrow Transplantation) outlines their screening and preventive recommendations for dyslipidemia, hypertension, abdominal obesity, insulin resistance/diabetes mellitus, coronary heart disease, and ischemic stroke.

The report also describes clinical factors that increase the risk that HCT recipients will develop MetS, including TBI as part of pre-transplant conditioning, development of acute or chronic GVHD, and ongoing therapy with corticosteroids, calcineurin inhibitors and sirolimus.

DeFilipp Z, et al. Bone Marrow Transplant

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