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Impact of body mass index at different transplantation stages on postoperative outcomes in patients with hematological malignancies: a meta-analysis

Bone Marrow Transplantation volume 53, pages 708–721 (2018)Cite this article

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Abstract

Although the association between body mass index (BMI) and overall survival (OS) has been reported in leukemia patients of different ages, whether BMI levels at different stages of hematopoietic stem cell transplantation (HSCT) have different effects on postoperative survival remains controversial. We searched four electronic databases from inception through July 2017 without any language restrictions and included studies on different types of hematological malignancies reporting both BMI time points and HSCT. Of the 1420 articles identified, 26 articles were eligible for inclusion in this meta-analysis. Three weight groups (obese, overweight and underweight) were individually compared with the normal group. Summary risk estimates for OS and event-free survival (EFS) were calculated with random- or fixed-effects models. For BMI at the pre-HSCT stage, a statistically significant positive association of increased risk of OS (RR: 1.17; 95% CI: 1.08–1.27) and EFS (RR: 1.29; 95% CI: 1–1.67) was identified in underweight individuals compared with those with normal weights. For BMI in the HSCT stage, a lower BMI was significantly associated with poorer OS (RR: 1.34; 95% CI: 1.01–1.78) and EFS (RR: 1.53; 95% CI: 1.09–2.06) compared with a normal BMI. Our results indicated that lower BMI at the pre-HSCT stage or during HSCT is associated with poorer survival.

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Acknowledgements

We thank the anonymous reviewers for their helpful suggestions. This work was supported by the National Natural Science Foundation of China (no. 81703221 to GR) and the Special Fund for Basic Scientific Research (no. 1610422016003 to GR and no. 1610422017007 to GR). ORCID profile (Dr. Guangxu Ren): 0000-0003-2378-260×.

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GR designed the research. GR and WC conducted the research. SY, LW, LL, JH and JW analyzed the data. GR drafted the manuscript.

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  1. These authors contributed equally: Guangxu Ren, Wei Cai.

Authors and Affiliations

  1. Institute of Food and Nutrition Development, Ministry of Agriculture, 100081, Beijing, China

    Guangxu Ren, Liping Wang, Jiazhang Huang, Suqin Yi, Lingang Lu & Jing Wang

  2. Qinhai University Affiliated Hospital, 810001, Xining, China

    Wei Cai

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Ren, G., Cai, W., Wang, L. et al. Impact of body mass index at different transplantation stages on postoperative outcomes in patients with hematological malignancies: a meta-analysis. Bone Marrow Transplant 53, 708–721 (2018). https://doi.org/10.1038/s41409-018-0234-1

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