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The impact of pre-transplant body weight on short- and long-term outcomes after allogeneic hematopoietic cell transplantation in adults using different weight classification tools

Bone Marrow Transplantation volume 51, pages 144–147 (2016)Cite this article

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The impact of pre-transplant body weight on outcomes after allogeneic hematopoietic cell transplantation (allo-HCT) remains controversial, and available data are limited by the use of different classification tools and the arbitrary determination of cutoff values. Most working groups have applied similar but slightly different body mass index (BMI) classifications according to the World Health Organization (WHO BMI) and the remainder employed very different cutoff values from the ratio of actual to ideal body weight (IBW).1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 Furthermore, the follow-up period for outcomes considered in one part of the studies covered at most the first post transplant year.3, 6, 9, 10

This therefore reveals the strengths of the present retrospective analysis, as we investigated for the first time the validity of three different weight classification tools using standard cutoffs as pre-transplant prognostic factors, a long follow-up period of 7.2 years and a consistent chemotherapy dose adjustment in obese patients (Table 1) compared with most other studies with no adjustment or relevant information.1, 2, 3, 5, 9, 11 The considered outcomes were overall survival (OS), PFS, relapse, nonrelapse mortality (NRM), acute GvHD (aGvHD) and chronic GvHD (cGvHD) and leukocyte engraftment. Beside the standard BMI classification of the WHO and IBW calculated using Devine’s equation (Table 1), we also captured age- and gender-adjusted BMI percentiles (adjusted BMI) of a current, representative German reference population.12 This allowed us to further categorize each BMI value as low (<10th percentile), normal (10–90th percentile) or high (>90th percentile).

Table 1 Patient and transplant characteristics (n=1190)
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Acknowledgements

We thank Carole Cürten for editorial assistance, Jakob Birlinger for data preparation, Irmgard Matt for data management and the staff of BMT Unit Löhr for patient care.

Author contributions

PU, JF and HB contributed to conception, design and assembly of data. GI and PU performed data analysis and statistical analysis. All authors drafted the manuscript, saw and approved the final version of the manuscript.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Section of Nutrition and Dietetics, University Medical Center Freiburg, Freiburg, Germany

    P Urbain & H Bertz

  2. Clinical Trials Unit, University Medical Center Freiburg, Freiburg, Germany

    G Ihorst

  3. Department of Hematology and Oncology, University Medical Center Freiburg, Freiburg, Germany

    J Finke & H Bertz

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  1. P Urbain
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Correspondence to P Urbain.

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Urbain, P., Ihorst, G., Finke, J. et al. The impact of pre-transplant body weight on short- and long-term outcomes after allogeneic hematopoietic cell transplantation in adults using different weight classification tools. Bone Marrow Transplant 51, 144–147 (2016). https://doi.org/10.1038/bmt.2015.219

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