Outcomes in bone marrow transplant recipients with and without diabetes: A propensity-matched analysis using TriNetX database.

Abstract

e18557 Background: Bone Marrow Transplant is a high-risk intervention with clinically significant complications. Diabetes Mellitus is a pervasive condition globally. Here we explore outcomes of BMT in patients with and without diabetes mellitus. Methods: This retrospective cohort study utilized the TriNetX database to evaluate outcomes in bone marrow transplant recipients with and without diabetes. Propensity score matching was performed to control for differences in demographic and clinical characteristics, such as age, gender, and comorbid conditions, ensuring a balanced comparison between the two groups. Results: Before propensity matching, significant demographic and clinical differences were evident. Diabetic patients were older (62.0 years vs. 51.5 years, p < 0.001) and had a higher prevalence of comorbidities, such as hypertensive diseases (64.9% vs. 30.8%, p < 0.001) and ischemic heart diseases (22.3% vs. 8.0%, p < 0.001). Gender distribution also differed, with fewer females in the diabetic group (39.4% vs. 42.7%, p < 0.001). After 1:1 propensity score matching, these demographic differences were effectively neutralized, demonstrating the efficacy of the matching process. A total of 12944 patients were identified in the Bone Marrow Transplant without DM group and 12952 patients were identified in the Bone Marrow Transplant with DM group. The propensity-matched outcomes revealed that diabetes significantly increased the odds of adverse outcomes. Diabetic patients had higher risks of bone marrow transplant rejection (OR 1.472, CI 1.346–1.610, p < 0.001), failure (OR 1.427, CI 1.301–1.564, p < 0.001), and infection (OR 2.292, CI 1.695–3.100, p < 0.001). Mortality was also elevated (OR 1.218, CI 1.153–1.287, p < 0.001), as were risks of heart failure (OR 1.403, CI 1.314–1.498, p < 0.001) and acute kidney injury (OR 1.343, CI 1.274–1.416, p < 0.001). Conclusions: Diabetes significantly worsens outcomes in bone marrow transplant recipients, increasing the risks of rejection, failure, infection, and mortality, even after adjusting for baseline differences through propensity score matching. These findings underscore the importance of close monitoring and tailored management strategies for diabetic bone marrow transplant recipients. The study highlights the value of propensity matching in isolating the effects of diabetes on transplant outcomes. Outcomes in bone marrow transplant patients with and without diabetes. Condition Odds Ratio CI Lower Bound CI Upper Bound p-value Bone marrow transplant Rejection 1.472 1.346 1.610 <0.001 Bone marrow transplant Failure 1.427 1.301 1.564 <0.001 Bone marrow transplant Infection 2.292 1.695 3.100 <0.001 Death 1.218 1.153 1.287 <0.001 Heart Failure 1.403 1.314 1.498 <0.001 Acute Kidney 1.343 1.274 1.416 <0.001