A retrospective study on beta-blocker use and outcomes in hematopoietic stem cell transplant patients.

Recent studies have linked beta-blocker (BB) use in critical care settings with improved survival outcomes, potentially due to beta-adrenergic receptor (β-AR) blockade and associated anti-inflammatory effects. Given the immune system's role in the development of graft-versus-host disease (GVHD)-a major complication of allogeneic hematopoietic stem cell transplant (allo-HCT)-we conducted a single-center retrospective review to assess the impact of BB use on acute GVHD (aGVHD) and other survival outcomes in patients undergoing their first allo-HCT. We analyzed 10 years of data (January 2010 to May 2020), including 105 patients who received a BB for more than four days before and after HCT, and 669 control patients who did not receive a BB. Patients on BBs had a lower incidence of aGVHD (55.2% vs. 65.8%, p = 0.036); however, this difference was not statistically significant in multivariate analysis (p = 0.150). When stratified by BB mechanism, outcomes varied: non-selective BBs were associated with lower post-HCT weight (p = 0.034), and vasodilating BBs showed a borderline reduction in length of stay (LOS) (p = 0.054). While our findings confirm the pharmacological safety of BBs in this population, they do not support their routine use for modifying allo-HCT outcomes. Future prospective studies with larger cohorts are needed to further explore the role of BBs in peri-HCT management and to clarify their clinical implications and therapeutic potential.

Duke Scholars

Author Richard D Lopez Medicine, Hematologic Malignancies and Cellular Therapy

Author Mitchell Eric Horwitz Medicine, Hematologic Malignancies and Cellular Therapy

Author Keith Michael Sullivan Medicine, Hematologic Malignancies and Cellular Therapy

Author Nelson Jen An Chao Medicine, Hematologic Malignancies and Cellular Therapy

Author Paul Edmund Wischmeyer Anesthesiology, Critical Care Medicine

Author Taewoong Choi Medicine, Hematologic Malignancies and Cellular Therapy

Author Cristina Gasparetto Medicine, Hematologic Malignancies and Cellular Therapy