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

Bone Marrow Transplantation volume 50, pages 402–410 (2015)Cite this article

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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.

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Acknowledgements

We are grateful to the patients, their families and the clinical personnel who participated in this study. We thank the BMT Program Team at the Clinical Trials Office at the University of Michigan for data collection and management. MG was supported by the Student Biomedical Research Program at the University of Michigan Medical School, funded by a training grant from the National Institutes of Health to Dr Benjamin L Margolis (T35HL007690). This study was supported by a grant to SWC from the National Institutes of Health (1K23AI091623). SWC is an A Alfred Taubman Institute/Edith Briskin/SKS Foundation Emerging Scholar.

Author Contributions

MG collected and analyzed the data and drafted and approved the manuscript; YL analyzed the data and approved the manuscript; LC collected and analyzed the data and approved the manuscript; SP conducted scientific analyses and approved the manuscript; DAH collected the data and approved the manuscript; DGF collected and analyzed the data and approved the manuscript; CAB cared for patients and approved the manuscript; PRR designed the study, cared for patients and approved the manuscript; TMB designed the study, analyzed the data and approved the manuscript; SWC designed the study, cared for patients, collected and analyzed the data and drafted and approved the manuscript.

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Authors and Affiliations

  1. University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA

    M Gleimer

  2. Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA

    Y Li & T M Braun

  3. Division of Pediatric Hematology/Oncology, Department of Pediatrics, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, MI, USA

    L Chang, C A Byersdorfer & S W Choi

  4. Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA

    S Paczesny

  5. Division of General Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA

    D A Hanauer

  6. Informatics Core of the Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, USA

    D A Hanauer

  7. College of Pharmacy, University of Michigan, Ann Arbor, MI, USA

    D G Frame

  8. Division of Hematology/Oncology, Department of Internal Medicine, Blood and Marrow Transplantation Program, University of Michigan, Ann Arbor, MI, USA

    P R Reddy

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  1. M Gleimer
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Correspondence to S W Choi.

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Gleimer, M., Li, Y., Chang, L. et al. Baseline body mass index among children and adults undergoing allogeneic hematopoietic cell transplantation: clinical characteristics and outcomes. Bone Marrow Transplant 50, 402–410 (2015). https://doi.org/10.1038/bmt.2014.280

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