title: Metabolic Syndrome and Cardiovascular Disease after Hematopoietic Cell Transplantation: Screening and Preventive Practice Recommendations from the CIBMTR and EBMT.
abstract: Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors that increases the risk of cardiovascular disease, diabetes mellitus, and all-cause mortality. Long-term survivors of hematopoietic cell transplantation (HCT) have a substantial risk of developing MetS and cardiovascular disease, with an estimated prevalence of MetS of 31% to 49% among HCT recipients. Although MetS has not yet been proven to impact cardiovascular risk after HCT, an understanding of the incidence and risk factors for MetS in HCT recipients can provide the foundation to evaluate screening guidelines and develop interventions that may mitigate cardiovascular-related mortality. A working group was established through the Center for International Blood and Marrow Transplant Research and the European Group for Blood and Marrow Transplantation with the goal to review literature and recommend practices appropriate to HCT recipients. Here we deliver consensus recommendations to help clinicians provide screening and preventive care for MetS and cardiovascular disease among HCT recipients. All HCT survivors should be advised of the risks of MetS and encouraged to undergo recommended screening based on their predisposition and ongoing risk factors.
authors.affiliation: Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia.
authors.forename: Zachariah
authors.initials: Z
authors.lastname: DeFilipp
authors.affiliation: Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
authors.forename: Rafael F
authors.initials: RF
authors.lastname: Duarte
authors.affiliation: Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust and Department of Oncology & Metabolism, University of Sheffield, Sheffield, United Kingdom.
authors.forename: John A
authors.initials: JA
authors.lastname: Snowden
authors.affiliation: Department of Hematology and Oncology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Navneet S
authors.initials: NS
authors.lastname: Majhail
authors.affiliation: Specialized Cancer Services, Sheffield Teaching Hospital NHS Foundation Trust, Shefflied, United Kingdom.
authors.forename: Diana M
authors.initials: DM
authors.lastname: Greenfield
authors.affiliation: Department of Medicine, Reina Sofia University Hospital, Maimonides Institute for Biomedical Research at Cordoba (IMIBIC), University of Cordoba, CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Spain.
authors.forename: José López
authors.initials: JL
authors.lastname: Miranda
authors.affiliation: Florence Nightingale Sisli Hospital, Hematopoietic Stem Cell Transplantation Unit, Istanbul, Turkey.
authors.forename: Mutlu
authors.initials: M
authors.lastname: Arat
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: K Scott
authors.initials: KS
authors.lastname: Baker
authors.affiliation: National Marrow Donor Program, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Burns
authors.affiliation: Pediatric Stem Cell Transplant, Dana-Farber Cancer Institute, Boston, Massachusetts.
authors.forename: Christine N
authors.initials: CN
authors.lastname: Duncan
authors.affiliation: Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.
authors.forename: Maria
authors.initials: M
authors.lastname: Gilleece
authors.affiliation: All Children's Hospital, John Hopkins Medicine, St. Petersburg, Florida.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Hale
authors.affiliation: Center for International Blood and Marrow Transplant Research (CIBMTR), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Hamadani
authors.affiliation: Department of Hematology and Oncology, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Betty K
authors.initials: BK
authors.lastname: Hamilton
authors.affiliation: Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
authors.forename: William J
authors.initials: WJ
authors.lastname: Hogan
authors.affiliation: Division of Hematology & Oncology, Department of Medicine, University of Florida, Gainesville, Florida.
authors.forename: Jack W
authors.initials: JW
authors.lastname: Hsu
authors.affiliation: Division of Hematopoietic Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Inamoto
authors.affiliation: Division of Hematology and Oncology, Center for Cell and Gene Therapy, Baylor College of Medicine, Houston, Texas.
authors.forename: Rammurti T
authors.initials: RT
authors.lastname: Kamble
authors.affiliation: Hematology and Bone Marrow Transplantation Unit, San Raffaele Scientific Institute, Milano, Italy.
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Lupo-Stanghellini
authors.affiliation: Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Adriana K
authors.initials: AK
authors.lastname: Malone
authors.affiliation: Roswell Park Cancer Institute, BMT Program, Department of Medicine, Buffalo, New York.
authors.forename: Philip
authors.initials: P
authors.lastname: McCarthy
authors.affiliation: University Pierre & Marie Curie, Paris, France; Hopital Saint-Antoine, AP-HP, Paris, France; INSERM UMRs 938, Paris, France.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Mohty
authors.affiliation: Division of Hematology & Oncology, Department of Medicine, University of Florida, Gainesville, Florida.
authors.forename: Maxim
authors.initials: M
authors.lastname: Norkin
authors.affiliation: Roswell Park Cancer Institute, BMT Program, Department of Medicine, Buffalo, New York.
authors.forename: Pamela
authors.initials: P
authors.lastname: Paplham
authors.affiliation: Department Hematology, Oncology and Bone Marrow Transplant, UMass Memorial Medical Center, Worcester, Massachusetts.
authors.forename: Muthalagu
authors.initials: M
authors.lastname: Ramanathan
authors.affiliation: Saint Louis University, Department of Internal Medicine, Division of Hematology and Medical Oncology, St. Louis, Missouri.
authors.forename: John M
authors.initials: JM
authors.lastname: Richart
authors.affiliation: Hammersmith Hospital, London, United Kingdom.
authors.forename: Nina
authors.initials: N
authors.lastname: Salooja
authors.affiliation: Maastricht University Medical Center, Maastricht, The Netherlands.
authors.forename: Harry C
authors.initials: HC
authors.lastname: Schouten
authors.affiliation: Department of Hematology, University Hospital Leuven and KU Leuven, Leuven, Belgium.
authors.forename: Helene
authors.initials: H
authors.lastname: Schoemans
authors.affiliation: Hospital Samaritano, Sao Paulo, Brazil; Associação da Medula Ossea - AMEO, Sao Paulo, Brazil.
authors.forename: Adriana
authors.initials: A
authors.lastname: Seber
authors.affiliation: Division of Hematology/Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Amir
authors.initials: A
authors.lastname: Steinberg
authors.affiliation: Department of Internal Medicine, Stony Brook University Medical Center, Stony Brook, New York.
authors.forename: Baldeep M
authors.initials: BM
authors.lastname: Wirk
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina.
authors.forename: William A
authors.initials: WA
authors.lastname: Wood
authors.affiliation: Hematology Branch, National Institutes of Health, Bethesda, Maryland.
authors.forename: Minoo
authors.initials: M
authors.lastname: Battiwalla
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington.
authors.forename: Mary E D
authors.initials: MED
authors.lastname: Flowers
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Bipin N
authors.initials: BN
authors.lastname: Savani
authors.affiliation: Center for International Blood and Marrow Transplant Research (CIBMTR), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Electronic address: bshaw@doctors.org.uk.
authors.forename: Bronwen E
authors.initials: BE
authors.lastname: Shaw
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000209:etiology*; D012307:Risk Factors; D014184:Transplantation, Homologous
keywords: Cardiovascular disease; Hematopoietic cell transplantation; Late effects; Metabolic syndrome; Survivorship