The effect of uric acid levels on the outcomes of patients having an allogeneic stem cell transplant

This study aimed to investigate the association of uric acid levels before a stem cell transplant and patient outcomes. This study concluded that high uric acid levels before the transplant led to increased mortality.

Uric acid is a product of metabolic breakdown and is a normal component of urine. It can also be a danger signal leading to inflammation. 

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a procedure in which a person receives blood-forming stem cells from a genetically similar, but not identical, donor. This is often a sister or brother but could be an unrelated donor. Studies have shown that a reduction of uric acid leads to improved survival after alloHSCT and reduced graft-versus-host-disease (GVHD). GVHD is where the cells that have been transplanted attack the patient.  

It was unknown how uric acid levels would affect the outcomes of alloHSCT in patients with leukemia or lymphoma.  

This study involved 366 patients with acute leukemia and lymphoma. All patients received a first matched sibling alloHSCT. The outcomes for patients with high and low uric acid levels were compared. Patients were followed for an average of 15.2 months. 

There was no difference between patients in terms of pre-existing medical conditions in addition to leukemia/lymphoma. Also, there was no difference regarding the disease stage between the groups with high and low uric acid levels. The occurrence of acute GVHD did not differ significantly between the low and high uric acid groups.  

The group with higher uric acid levels had a significantly shorter overall survival rate and progression-free survival (PFS; survival without the disease getting worse) rate compared to the group with lower uric acid levels. 

Also, non-relapse mortality (death not related to cancer returning) was significantly higher in the group with high uric acid levels when compared to the group with low uric acid levels. The occurrence of relapse (cancer returns) after alloHSCT was higher in the group with high uric acid levels compared to those with low uric acid levels. 

This study concluded that high uric acid levels before transplant led to a lower survival rate in patients with leukemia and lymphoma. 

All patients included in this trial had HLA-identical sibling donors for the SCT. Further larger studies are needed for patients with unidentical donors.

Consult your physician if you have concerns about uric acid levels.