The impact of pre-transplantation diabetes and obesity on acute graft-versus-host disease, relapse and death after allogeneic hematopoietic cell transplantation: a study from the EBMT Transplant Complications Working Party

Lars Klingen Gjaerde, Tapani Ruutu, Christophe Peczynski, William Boreland, Nicolaus Kroeger, Didier Blaise, Thomas Schroeder, Regis Peffault de Latour, Tobias Gedde-Dahl, Aleksandr Kulagin, Henrik Sengelov, Ibrahim Yakoub-Agha, Juergen Finke, Matthias Eder, Grzegorz Basak, Ivan Moiseev, Helene Schoemans, Christian Koenecke, Olaf Penack, Zinaida Peric

Research output: Contribution to journalArticleScientificpeer-review


Obesity and diabetes can modulate immune responses, which may impact allogeneic HCT outcomes and GvHD. From the EBMT registry, we included 36,539 adult patients who underwent allogeneic HCT for a hematological malignancy between 2016 and 2020. Of these, 5228 (14%) had obesity (BMI >= 30 kg/m(2)), 1415 (4%) had diabetes (requiring treatment with insulin or oral hypoglycemics), and 688 (2%) had obesity + diabetes pre-transplantation. Compared with patients without diabetes or obesity, the hazard ratio (HR) of grade II-IV acute GvHD was 1.00 (95% confidence interval [CI] 0.94-1.06, p = 0.89) for patients with obesity, 0.95 (CI 0.85-1.07, p = 0.43) for patients with diabetes, and 0.96 (CI 0.82-1.13, p = 0.63) for patients with obesity + diabetes. Non-relapse mortality was higher in patients with obesity (HR 1.08, CI 1.00-1.17, p = 0.047), diabetes (HR 1.40, CI 1.24-1.57, p < 0.001), and obesity + diabetes (HR 1.38, CI 1.16-1.64, p < 0.001). Overall survival after grade II-IV acute GvHD was lower in patients with diabetes (HR 1.46, CI 1.25-1.70, p < 0.001). Pre-transplantation diabetes and obesity did not influence the risk of developing acute GvHD, but pre-transplantation diabetes was associated with poorer survival after acute GvHD.
Original languageEnglish
JournalBone Marrow Transplantation
Number of pages9
Publication statusPublished - Dec 2023
MoE publication typeA1 Journal article-refereed

Fields of Science

  • 3121 General medicine, internal medicine and other clinical medicine
  • Body-mass index
  • Children
  • Outcomes
  • Hyperglycemia
  • Dysfunction
  • Risk

Cite this