HCT recipients may be at an increased risk of developing hypertension, diabetes and dyslipidemia (referred to as cardiovascular risk factors ([CVRFs]); and these can potentially increase the risk of cardiovascular disease (CVD). We examined the incidence and predictors of CVRFs and subsequent CVD in 1885 consecutive 1+year survivors of HCT performed at City of Hope between 1995 and 2004. Ten-year cumulative incidence (CI) of hypertension, diabetes, dyslipidemia, and multiple (≥2) CVRFs was 37.7%, 18.1%, 46.7%, and 31.4%, respectively. The prevalence of CVRFs was significantly higher among HCT recipients compared to the general population; contributed to largely by allogeneic HCT recipients. Older age and obesity at HCT were associated with increased risk of CVRFs. History of Grade II-IV acute graft versus host disease was associated with an increased risk for hypertension (RR=9.1, p<0.01), diabetes (RR=5.8, p<0.01) and dyslipidemia (RR=3.2, p<0.01); conditioning with total body irradiation was associated with an increased risk of diabetes (RR=1.5, p=0.01) and dyslipidemia (RR=1.4, p<0.01). There was an incremental increase in 10-year incidence of CVD by number of CVRFs (4.7% [none], 7.0% [1 CVRF], 11.2% [≥2 CVRFs], p<0.01); the risk was especially high (15.0%) in patients with multiple CVRFs and pre-HCT exposure to anthracyclines or chest radiation.
- Submitted June 13, 2012.
- Accepted August 14, 2012.
- Copyright © 2005 American Society of Hematology