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

M. Gleimer, Y. Li, L. Chang, S. Paczesny, D. A. Hanauer, D. G. Frame, C. A. Byersdorfer, P. R. Reddy, T. M. Braun, S. W. Choi

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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.

Original languageEnglish (US)
Pages (from-to)402-410
Number of pages9
JournalBone marrow transplantation
Volume50
Issue number3
DOIs
StatePublished - Mar 1 2015

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ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Gleimer, M., Li, Y., Chang, L., Paczesny, S., Hanauer, D. A., Frame, D. G., Byersdorfer, C. A., Reddy, P. R., Braun, T. M., & Choi, S. W. (2015). Baseline body mass index among children and adults undergoing allogeneic hematopoietic cell transplantation: Clinical characteristics and outcomes. Bone marrow transplantation, 50(3), 402-410. https://doi.org/10.1038/bmt.2014.280