title: Association of hyperglycemia with prolonged hospital stay but no effect on engraftment after autologous hematopoietic stem cell transplantation.
abstract: OBJECTIVE
  To determine the effect of hyperglycemia, which is associated with poor outcome of various diseases, on the outcome of hematopoietic stem cell transplantation (HSCT).
  
  
  METHODS
  We examined the influence of blood glucose concentration (BGC) on the outcome of autologous HSCT. Patients had at least one BGC determination every morning during their hospitalization. The relationships of BGC with time to engraftment and length of hospital stay (LOHS) after transplantation were analyzed.
  
  
  RESULTS
  The correlation of LOHS after transplantation was found only with posttransplant averaged BGC (P=.0004) in patients without diabetes (N = 240) but not with pretransplant averaged BGC or BGC on the morning of transplantation. The correlation remained significant after adjustment for sex, age, and body mass index (P=.0002) and for use of glucocorticoids and total parenteral nutrition (P=.04). No correlation was observed, however, between BGC and timing of engraftment. We further analyzed the entire data set of subjects (N = 335) on the basis of posttransplant morning BGC and divided these patients into 2 groups: those with BGC <150 mg/dL and those with BGC ≥150 mg/dL. No difference in engraftment time was noted between these 2 groups, but a correlation was observed with LOHS after transplantation (14 ± 4 days versus 17 ± 6 days, respectively; P<.0001).
  
  
  CONCLUSIONS
  We observed that posttransplant averaged BGC significantly correlated with LOHS after transplantation. BGC, however, had no effect on the timing of engraftment. Thus, our results suggest that better glycemic control could potentially shorten hospital stay after HSCT.
authors.affiliation: Department of Clinical Diabetes, Endocrinology, and Metabolism, City of Hope National Medical Center, Duarte, California 91010-3000, USA.
authors.forename: Rudruidee
authors.initials: R
authors.lastname: Karnchanasorn
authors.forename: Lou Rose
authors.initials: LR
authors.lastname: Malamug
authors.forename: Rami
authors.initials: R
authors.lastname: Jin
authors.forename: Chatchada
authors.initials: C
authors.lastname: Karanes
authors.forename: Ken C
authors.initials: KC
authors.lastname: Chiu
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D015331:Cohort Studies; D005260:Female; D006085:Graft Survival; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000209:etiology* / Q000276:immunology / Q000503:physiopathology; D007902:Length of Stay; D007958:Leukocyte Count; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology; D010976:Platelet Count; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013312:Stress, Physiological; D014182:Transplantation, Autologous
chemical_list: D001786:Blood Glucose