Early Hyperglycemia after Initiation of Glucocorticoid Therapy Predicts Adverse Outcome in Patients with Acute Graft-versus-Host Disease Melanie N. Stauber,

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Early Hyperglycemia after Initiation of Glucocorticoid Therapy Predicts Adverse Outcome in Patients with Acute Graft-versus-Host Disease Melanie N. Stauber, Felix Aberer, Abderrahim Oulhaj, Julia K. Mader, Armin Zebisch, Thomas R. Pieber, Peter Neumeister, Hildegard T. Greinix, Heinz Sill, Harald Sourij, Albert Wölfler Biology of Blood and Marrow Transplantation Volume 23, Issue 7, Pages 1186-1192 (July 2017) DOI: 10.1016/j.bbmt.2017.03.010 Copyright © 2017 The American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 (A) Probability of survival of patients with aGVHD according to their mean glucose levels during GC treatment. Patients (n = 104) were assigned into tertiles (the range of mean glucose values were as follows: tertile 1 (black line): 86.9 to 127.6 mg/dL; tertile 2 (red line): 128.3 to 164.7 mg/dL; tertile 3 (blue line): 165.7 to 255.4 mg/dL). Tertiles representing increasing mean glucose levels were associated with shorter OS (P < .0001 for trend). (B) OS in patients during GC therapy according to treatment with insulin. Treatment with insulin (red line) was associated with increased risk of death (P = .0005; HR, 2.52; 95% CI, 1.49 to 4.24). Biology of Blood and Marrow Transplantation 2017 23, 1186-1192DOI: (10.1016/j.bbmt.2017.03.010) Copyright © 2017 The American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 (A) Probability of survival of patients (n = 104) according to their mean glucose levels during the first 3 days of GC treatment. Patients with early hyperglycemia defined by a mean glucose value above 125 mg/dL (red line) had an increased risk of death (HR, 2.9; 95% CI, 1.77 to 4.75; P = .0002). (B) Impact of early hyperglycemia on cumulative incidence of NRM. Cumulative incidence of NRM was highly significantly associated with early hyperglycemia (red line) as determined by risk analysis on competing causes of death (HR, 3.88; 95% CI, 1.73 to 8.72; P = .001). (C) No role of early hyperglycemia on cumulative incidence of relapse-related death. Cumulative incidence of death due to relapse was not associated with early hyperglycemia (P = .85). Biology of Blood and Marrow Transplantation 2017 23, 1186-1192DOI: (10.1016/j.bbmt.2017.03.010) Copyright © 2017 The American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 3 (A) Probability of survival of patients with aGVHD (n = 104) according to their score (score 0: black line; score 1: red line; score 2: blue line). An increasing score was significantly associated with shorter OS (P < .0001 for trend). (B) Impact of the score on cumulative incidence of NRM. Cumulative incidence of NRM in patients with aGVHD was highly significantly associated with an increasing score as determined by risk analysis on competing causes of death (P = .0001 for trend). (C) No role of early hyperglycemia on cumulative incidence of relapse-related death. Cumulative incidence of death due to relapse was not associated with the score (P = .18). Biology of Blood and Marrow Transplantation 2017 23, 1186-1192DOI: (10.1016/j.bbmt.2017.03.010) Copyright © 2017 The American Society for Blood and Marrow Transplantation Terms and Conditions