title: Possible association between obesity and posttransplantation complications including infectious diseases and acute graft-versus-host disease.
abstract: Both obesity and malnutrition are considered risk factors for complications after bone marrow transplantation (BMT). To elucidate the impact of pretransplantation body mass index (BMI) on clinical outcome, we performed a retrospective cohort study with registration data from the Japan Marrow Donor Program (JMDP). Between January 1998 and December 2005, a total of 3935 patients received unrelated BMT through the JMDP; of these, 3827 patients for whom pretransplantation height and weight data were available were included in the study. Patients were stratified according to pretransplantation BMI values (low BMI: BMI < 18 kg/m(2), n = 295; normal BMI: 18 < or = BMI < 25 kg/m(2), n = 2906; overweight: 25 < or = BMI <30 kg/m(2), n = 565; obese: 30 kg/m(2) < or = BMI, n = 61). In a univariate analysis, pretransplantation BMI was associated with a significantly greater risk of grade II-IV acute graft-versus-host disease (GVHD; P = .03). Multivariate analysis showed that pretransplantation BMI tended to be associated with an increased risk of grade II-IV acute GVHD (P = .07). Obesity was associated with an increased risk of infection compared with normal BMI (odds ratio = 1.9; 95% confidence interval = 1.1 to 3.2; P = .02). Our findings demonstrate a correlation between pretransplantation BMI and posttransplantation complications. Although BMI depends strongly on multiple factors, the effect of obesity on clinical outcome should be evaluated in a prospective study.
authors.affiliation: Department of Hematology and Stem Cell Transplantation, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Fuji
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Kim
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Yoshimura
authors.forename: Hideki
authors.initials: H
authors.lastname: Akiyama
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Okamoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sao
authors.forename: Junko
authors.initials: J
authors.lastname: Takita
authors.forename: Naoki
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Mori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D003141:Communicable Diseases / Q000209:etiology*; D006086:Graft vs Host Disease / Q000209:etiology*; D006801:Humans; D044342:Malnutrition / Q000150:complications; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors