Scientists link hematopoietic cell transplant deaths to beta-blocker use (Stem cell transplants)

Medical Xpress / UT Southwestern Medical Center / Cancer Discovery ^ | Dec. 31, 2024 | Jinsuke Nishino et al

[ConservativeMind]

Patients can die if they take certain previously prescribed beta-blockers during a hematopoietic cell transplant due to suppressed signals from nerves that promote bone marrow regeneration.

This finding by scientists builds upon previous research by analyzing retrospective patient data to correlate beta-blocker use with significantly worse patient outcomes.

Hematopoietic cell transplants are commonly used to treat disorders of the blood-forming system, including some high-risk leukemias. During treatment, a patient's blood-forming cells are wiped out with chemotherapy and radiation and replaced with transplanted hematopoietic cells.

There are three beta-adrenergic receptors—β1, β2, and β3—that perform numerous functions across the body, primarily to relay signals from the sympathetic nervous system to various tissues.

Researchers hypothesized that non-selective beta-blockers, but not β1-selective inhibitors, would impair hematopoietic regeneration after transplantation, since β2 and β3 are necessary for bone marrow regeneration.

Dr. Nishino's findings showed that beta-blockers had no effect on normal blood cell production in non-transplanted mice.

However, in transplanted mice, non-selective beta-blockers impaired hematopoietic regeneration, but β1-selective inhibitors did not. Half of the mice treated with non-selective beta-blockers died after transplantation because they couldn't regenerate their bone marrow quickly enough.

"We analyzed 10 years of data and found that patients on non-selective beta-blockers take a much longer time to recover their blood counts. We further found this led to a significantly higher rate of complications and worse survival in patients."

"Nonetheless, our data suggest it's prudent that patients undergoing hematopoietic cell transplantation either discontinue non-selective beta-blockers for about three weeks or transition to a β1-selective inhibitor, if discontinuation is not feasible."

[ConservativeMind]

Non-selective beta blockers taken for the three weeks around a stem cell transplant worsens complications and survival.

This was not generally known to be a problem.

[ConservativeMind]

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