Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Pediatric Transplants

The effect of obesity on outcome of unrelated cord blood transplant in children with malignant diseases

Bone Marrow Transplantation volume 46, pages 1309–1313 (2011)Cite this article

Subjects

Abstract

Obesity has become a pandemic, affecting both children and adults. We sought to determine the effect of obesity among 200 children who were prospectively enrolled on a multicenter cord blood transplant (CBT) trial. All patients received myeloablative preparative regimens. Children were classified into groups according to body mass index percentile. Normal weight was defined as body mass index between the 5th and 85th percentile (n=117), overweight between the 85th and 95th percentile (n=35) and obesity above 95th percentile (n=39) for age and gender. A total of 55 patients (27%) had AML, 113 patients (57%) had ALL and 32 patients (16%) had other malignant diseases. There was no evidence for a difference in all major characteristics among the groups. Time to neutrophil and platelet engraftment, TRM, risk of acute GVHD, disease-free survival and OS were not significantly different in overweight or obese patients compared with normal weight patients. There was a trend towards increased risk of chronic GVHD in obese patients (P=0.05) compared with normal weight patients. In conclusion, there is insufficient evidence from this sample that obesity has an effect on multiple outcomes after unrelated CBT in children with malignant diseases.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Ogden CL, Carroll MD, Flegal KM . High body mass index for age among US children and adolescents, 2003–2006. JAMA 2008; 299: 2401–2405.

    Article  CAS  PubMed  Google Scholar 

  2. Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM . Prevalence of overweight and obesity in the United States, 1999–2004. JAMA 2006; 295: 1549–1555.

    Article  CAS  PubMed  Google Scholar 

  3. Deeg HJ, Seidel K, Bruemmer B, Pepe MS, Appelbaum FR . Impact of patient weight on non-relapse mortality after marrow transplantation. Bone Marrow Transplant 1995; 15: 461–468.

    CAS  PubMed  Google Scholar 

  4. Fleming DR, Rayens MK, Garrison J . Impact of obesity on allogeneic stem cell transplant patients: a matched case-controlled study. Am J Med 1997; 102: 265–268.

    Article  CAS  PubMed  Google Scholar 

  5. Fuji S, Kim SW, Yoshimura K, Akiyama H, Okamoto S, Sao H et al. Possible association between obesity and post-transplantation complications including infectious diseases and acute graft-versus-host disease. Biol Blood Marrow Transplant 2009; 15: 73–82.

    Article  PubMed  Google Scholar 

  6. Tarella C, Caracciolo D, Gavarotti P, Argentino C, Zallio F, Corradini P et al. Overweight as an adverse prognostic factor for non-Hodgkin′s lymphoma patients receiving high-dose chemotherapy and autograft. Bone Marrow Transplant 2000; 26: 1185–1191.

    Article  CAS  PubMed  Google Scholar 

  7. Lange BJ, Gerbing RB, Feusner J, Skolnik J, Sacks N, Smith FO et al. Mortality in overweight and underweight children with acute myeloid leukemia. JAMA 2005; 293: 203–211.

    Article  CAS  PubMed  Google Scholar 

  8. Bulley S, Gassas A, Dupuis LL, Aplenc R, Beyene J, Greenberg ML et al. Inferior outcomes for overweight children undergoing allogeneic stem cell transplantation. Br J Haematol 2008; 140: 214–217.

    PubMed  Google Scholar 

  9. Kurtzberg J, Prasad VK, Carter SL, Wagner JE, Baxter-Lowe LA, Wall D et al. Results of the Cord Blood Transplantation Study (COBLT): clinical outcomes of unrelated donor umbilical cord blood transplantation in pediatric patients with hematologic malignancies. Blood. 2008; 112: 4318–4327.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Martin PL, Carter SL, Kernan NA, Sahdev I, Wall D, Pietryga D et al. Results of the cord blood transplantation study (COBLT): outcomes of unrelated donor umbilical cord blood transplantation in pediatric patients with lysosomal and peroxisomal storage diseases. Biol Blood Marrow Transplant 2006; 12: 184–194.

    Article  PubMed  Google Scholar 

  11. Wall DA, Carter SL, Kernan NA, Kapoor N, Kamani NR, Brochstein JA et al. Busulfan/melphalan/antithymocyte globulin followed by unrelated donor cord blood transplantation for treatment of infant leukemia and leukemia in young children: the Cord Blood Transplantation study (COBLT) experience. Biol Blood Marrow Transplant 2005; 11: 637–646.

    Article  CAS  PubMed  Google Scholar 

  12. Weisdorf DJ, Hurd D, Carter S, Howe C, Jensen LA, Wagner J et al. Prospective grading of graft-versus-host disease after unrelated donor marrow transplantation: a grading algorithm versus blinded expert panel review. Biol Blood Marrow Transplant 2003; 9: 512–518.

    Article  PubMed  Google Scholar 

  13. Defining childhood overweight and obesity. Available from www.cdc.gov/obesity/childhood/defining.html; Accessed (11 September 2010).

  14. Barker CC, Agovi MA, Logan B, Lazarus HM, Ballen KK, Gupta V et al. Childhood obesity and outcomes after bone marrow transplantation for patients with severe aplastic anemia. Biol Blood Marrow Transplant 2010 (e-pub ahead of print September 2010).

  15. Navarro WH, Agovi MA, Logan BR, Ballen K, Bolwell BJ, Frangoul H et al. Obesity does not preclude safe and effective myeloablative hematopoietic cell transplantation (HCT) for acute myelogenous leukemia (AML) in adults. Biol Blood Marrow Transplant 2010; 16: 1442–1450.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Meloni G, Proia A, Capria S, Romano A, Trape G, Trisolini SM et al. Obesity and autologous stem cell transplantation in acute myeloid leukemia. Bone Marrow Transplant 2001; 28: 365–367.

    Article  CAS  PubMed  Google Scholar 

  17. Navarro WH, Loberiza Jr FR, Bajorunaite R, van Besien K, Vose JM, Lazarus HM et al. Effect of body mass index on mortality of patients with lymphoma undergoing autologous hematopoietic cell transplantation. Biol Blood Marrow Transplant 2006; 12: 541–551.

    Article  PubMed  Google Scholar 

  18. Hansen JA, Gooley TA, Martin PJ, Appelbaum F, Chauncey TR, Clift RA et al. Bone marrow transplants from unrelated donors for patients with chronic myeloid leukemia. N Engl J Med 1998; 338: 962–968.

    Article  CAS  PubMed  Google Scholar 

  19. Barker JN, Wagner JE . Umbilical cord blood transplantation: current practice and future innovations. Crit Rev Oncol Hematol 2003; 48: 35–43.

    Article  PubMed  Google Scholar 

  20. Sierra J, Storer B, Hansen JA, Bjerke JW, Martin PJ, Petersdorf EW et al. Transplantation of marrow cells from unrelated donors for treatment of high-risk acute leukemia: the effect of leukemic burden, donor HLA-matching, and marrow cell dose. Blood 1997; 89: 4226–4235.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgements

The Cord Blood Transplantation Study (COBLT) was conducted and supported by the NHLBI in collaboration with the COBLT study investigators. This manuscript was prepared using a limited access data set obtained from the NHLBI and does not necessarily reflect the opinions or views of the COBLT or the NHLBI. Supported in part by Vanderbilt CTSA grant UL1 RR024975 from NCRR/NIH.

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Pediatric Hematology/Oncology, Pediatric Stem Cell Transplant Program, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA

    M Pine, C Calder, B Manes, M Evans, J Domm & H Frangoul

  2. Department of Biostatistics, Vanderbilt University, Nashville, TN, USA

    L Wang & F E Harrell Jr

Authors
  1. M Pine
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. L Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F E Harrell Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C Calder
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. B Manes
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M Evans
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. J Domm
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. H Frangoul
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H Frangoul.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pine, M., Wang, L., Harrell, F. et al. The effect of obesity on outcome of unrelated cord blood transplant in children with malignant diseases. Bone Marrow Transplant 46, 1309–1313 (2011). https://doi.org/10.1038/bmt.2010.312

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2010.312

Keywords

This article is cited by

Search

Advanced search

Quick links