Premstaller M, et al. - In a large, single-centre cohort, the prevalence and treatment of dyslipidemia following hematopoietic stem cell transplantation (HSCT) was determined over a 25-year period. Findings corroborated that dyslipidemia is a common and long lasting phenomenon among both allogeneic and autologous HSCT patients. Notably, with good efficacy and good tolerability, statins should be highly recommended as a management option.

Methods

• This retrospective analysis included 1196 adult patients (≥16 years) who underwent HSCT 1973–2013 and who survived ≥100 days.

Results

• In the autologous and allogeneic groups, the reported prevalence of dyslipidemia before transplantation was 36% and 28%, respectively (p <0.001).
• A rise was noted in the prevalence after HSCT : at 3 months it was 62% and 74% (p <0.001), and at 25 years it was 67% and 89%.
• Following first and subsequent transplants, similar lipid profiles were reported.
• Independent risk factors for dyslipidemia at one year included baseline dyslipidemia (odds ratio [OR] 2.72), allogeneic transplant (OR 2.44) and age ≥ 35 years (OR 2.33).
• A total of 223 (19%) patients received lipid-lowering treatment, primarily in the form of statins (86%) and this treatment was related to a decrease in total cholesterol from 246 to 192mg/dL (p <0.01) and from 244 to 195mg/dL (p <0.001) in the autologous and allogeneic groups respectively.
• Data reported that 10 cases (4%) of muscle symptoms, including 1 case of rhabdomyolysis, prompted cessation of lipid-lowering therapy.
• In addition, results revealed that the odds ratio for dyslipidemia among patients who suffered a cardiovascular event (conditional logistic regression) was 3.5 (95% confidence interval 1.6 – 7.7, p = 0.002).