To Explore The Characteristics And Influencing Factors Of Dyslipidemia In Patients With Hematopoietic Stem Cell Transplantation

Objective:To study the characteristics of abnormal blood lipid metabolism in patients after hematopoietic stem cell transplantation(HSCT),to identify the influencing factors of abnormal blood lipid metabolism,and to provide clinical support for the treatment of abnormal blood lipid metabolism after transplantation.Methods:Data from adult patients who underwent HSCT in the transplantation unit of our hospital from January 2016 to January 2020 were studied.According to the type of transplantation,they were divided into autologous transplantation group and allogeneic transplantation group.Collect the patient’s lipid data,general clinical data,transplantation drug treatment and related complications after transplantation within100 days after transplantation.The rank sum test was used to compare blood lipid levels,and Logistic regression was used to analyze the influencing factors of hyperlipidemia.Results:99 out of 144 patients underwent allogeneic(allo-HSCT)and 45 underwent autogenous(auto-HSCT).The median age in the allo-HSCT group was 30(18-62)years,and the median age in the auto-HSCT group was 51(20-75)years.The incidence of elevated total cholesterol,triglycerides,and LDL cholesterol in the alloHSCT group at 1 month and 3 months after transplantation was significantly higher than that before transplantation(all p values were less than 0.001).The occurrence of reduction of HDL cholesterol at 1 month and 3 months after transplantation in alloHSCT group were significantly higher than that before transplantation(both p values were less than 0.05).Comparison of the incidence of elevated total cholesterol and LDL cholesterol before transplantation in the auto-HSCT group was higher than that in the allo-HSCT group(all p values were less than 0.05).There was no significant difference in the incidence of hypertriglyceridemia before transplantation between the two groups.The incidence of reduction HDL cholesterol before transplantation in the auto-HSCT group was lower than that in the allo-HSCT group(p<0.001).Patients in allo-HSCT group had significantly higher incidence of total cholesterol,triglycerides,and LDL cholesterol than that of the auto-HSCT group in 1 month after transplantation(all p values were less than 0.05).The occurrence of lower HDL cholesterol levels did not reach statistically significance between the two groups.The incidence of hypercholesterolemia and hypertriglyceridemia in allo-HSCT patients at 3 months after transplantation was significantly higher than that of auto-HSCT patients(all p values were less than 0.05).The incidence of elevated LDL cholesterol and lowered HDL cholesterol in the allo-HSCT group was not significantly different from that of the auto-HSCT group at 3 months after transplantation.In allo-HSCT patients,the incidence of elevated total cholesterol,triglycerides,and LDL cholesterol in 1 month and 3 months after haploidentical transplantation was significantly higher than that before transplantation(all p values were less than 0.05).However,there was no significant difference in the incidence of HDL-C reduction compared with that before transplantation.In the HLA-matched transplantation,the incidence of elevated total cholesterol and LDL cholesterol in 1 month and 3 months was significantly increased compared with that before transplantation(p-values are less than 0.05),and the incidence of elevated triglycerides and decreased HDL cholesterol did not reach statistically significance compared with that before transplantation.There was no significant difference in the incidence of hyperlipidemia between haploidentical and HLA-matched transplantation patients between 1 month and 3 months.Multivariate analysis found that patients with combined bacterial infection or type 2 diabetes after transplantation showed reduction of HDL cholesterol,which may be related.Conclusion:Abnormal blood lipid metabolism is a common complication after HSCT.Our study found that compared with auto-HSCT patients,allo-HSCT patients has a higher incidence of abnormal lipid metabolism,wider changes of lipid levels and longer duration of increased lipid levels.Compared with HLA-matched transplantation patients,haploidentical transplantation have a higher incidence of elevated total cholesterol,triglycerides,and LDL cholesterol.In the process of transplantation,especially haploidentical transplantation,an increase in the incidence of abnormal lipid metabolism has been observed.It is necessary to further explore The possible influencing factors and the impact on survival and prognosis need further studies.