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Investigating Associations Between Glycemic Status and Infections in Autologous Hematopoietic Cell Transplantation Recipients

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By: Published: 2017 | Product: SAGE Research Methods Cases in Health
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Abstract

Individuals undergoing allogeneic or autologous hematopoietic cell transplantation are at risk of abnormal blood glucose levels, termed malglycemia. Malglycemic events during cancer therapy can lead to adverse outcomes. To better understand the pathophysiological mechanisms between malglycemia and adverse events, we prospectively investigated associations between blood glucose levels, inflammatory cytokine expression, and infection risk in autologous hematopoietic cell transplantation recipients. The procedures, successes, challenges, and outcomes in conducting this prospective study are discussed in this research case study. Challenges of conducting this study included enrollment of ethnically diverse individuals, timing of enrollment, collection and processing of biological (blood) samples, and managing an unexpected natural disaster. Best study management strategies included creating an engaged team with mentors, PhD student research assistants, registered nurses, advanced practice nurses, and oncologists. Strong laboratory and statistical support led to successfully addressing the aims. Even with an unexpected major hurricane that temporarily closed the hospital where patients were enrolled in the study, we were able to complete this study. Findings included that hyperglycemia increased risk of infections and having a high body mass index added to the risk of both hyperglycemic events and infection. Increased inflammatory cytokines among patients with infections did not solicit an increase in leukocyte production, as it should have. Further investigation on a larger scale is warranted. Understanding the processes, procedures, and resources are essential for successfully conducting a prospective study, particularly with measuring biomarkers.

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