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Bone Marrow Transplant. 2015 Mar;50(3):402-10. doi: 10.1038/bmt.2014.280. Epub 2014 Dec 22.

Baseline body mass index among children and adults undergoing allogeneic hematopoietic cell transplantation: clinical characteristics and outcomes.

Author information

1
University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA.
2
Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA.
3
Division of Pediatric Hematology/Oncology, Blood and Marrow Transplantation Program, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA.
4
Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
5
1] Division of General Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA [2] Informatics Core of the Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, USA.
6
College of Pharmacy, University of Michigan, Ann Arbor, MI, USA.
7
Division of Hematology/Oncology, Blood and Marrow Transplantation Program, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.

Abstract

Obesity is an important public health problem that may influence the outcomes of hematopoietic cell transplantation (HCT). We studied 898 children and adults receiving first-time allogeneic hematopoietic SCTs between 2004 and 2012. Pretransplant body mass index (BMI) was classified as underweight, normal weight, overweight or obese using the WHO classification or age-adjusted BMI percentiles for children. The study population was predominantly Caucasian, and the median age was 51 years (5 months-73 years). The cumulative 3-year incidence of nonrelapse mortality (NRM) in underweight, normal weight, overweight and obese patients was 20%, 19%, 20% and 33%, respectively. Major causes of NRM were acute and chronic GVHD. The corresponding incidence of relapse was 30%, 41%, 37% and 30%, respectively. Three-year OS was 59%, 48%, 47% and 43%, respectively. Multivariate analysis showed that obesity was associated with higher NRM (hazard ratio (HR) 1.43, P=0.04) and lower relapse (HR 0.65, P=0.002). Pretransplant plasma levels of ST2 and TNFR1 biomarkers were significantly higher in obese compared with normal weight patients (P=0.04 and P=0.05, respectively). The increase in NRM observed in obese patients was partially offset by a lower incidence of relapse with no difference in OS.

PMID:
25531283
PMCID:
PMC4351174
DOI:
10.1038/bmt.2014.280
[Indexed for MEDLINE]
Free PMC Article

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