ESPE Abstracts

Objective: To investigate the characteristics of glucose metabolism in children with β-thalassemia major (β-TM) after allogeneic hematopoietic stem cell transplantation (HSCT), and to identify the factors that influence abnormal glucose metabolism after HSCT for children with β-TM.

Methods: A total of 41 children with β-TM who underwent HSCT at Hematopoietic Stem Cell Transplantation Department of Children's Medical Center of Sun Yat-sen Memorial Hospital, Sun Yat-sen University between January 2008 to December 2021were enrolled in this study based on inclusion and exclusion criteria. All participants were collected demographic data, primary disease diagnosis and treatment data, along with measurements of serum ferritin (SF), fasting insulin, fasting plasma glucose. Insulin release test and oral glucose tolerance test (OGTT) were conducted in 20 patients according to the voluntary principle to evaluate pancreatic islets β Cell function. Participants were divided into abnormal glucose homeostasis group and normal glucose homeostasis group based on the glucose metabolism at the time of evaluation, related indicators were analyze and compared, including genotype, SF before transplantation, heart T2* before transplantation, liver T2* before transplantation before transplantation, transplantation age, donor, source of stem cells, the occurrence and type of graft versus host disease (GVHD).

Results: 41.5% patient developed abnormal glucose metabolism after HSCT. 34.20% patients characterized by insulin resistance and no diabetes occurred. Among the children who underwent insulin release test and OGTT test, 45.00% had abnormal insulin release test. Comparing of various factors between abnormal glucose homeostasis group and normal glucose homeostasis group, it was showed that the average transplantation age was higher in abnormal glucose homeostasis group (P <0.05).

Conclusion: Abnormal glucose homeostasis is common in β-TM children after HSCT, consists largely of insulin resistance. Impaired pancreatic islets β-cell function may occur after HSCT in children with β-TM. The incidence of glucose homeostasis abnormality is higher in patients who undergo HSCT at an older age.