Survival in overweight and underweight children undergoing hematopoietic stem cell transplantation.
OBJECTIVE
There is a growing body of evidence that nutritional status influences the morbidity and mortality of children undergoing treatment for cancer. The aim of this paper is to determine if nutritional status is associated with survival post-pediatric bone marrow transplant.


METHODS
This was a single-center retrospective audit of patients who underwent an autologous or allogeneic hematopoietic stem cell transplant. Patients were divided into three weight categories of underweight, ideal weight and overweight defined by percent ideal body weight. The outcome of interest, overall post transplant survival, was compared between weight categories.


RESULTS
Of 113 patients, 15 (13%) were underweight and 41 (36%) were classified as overweight. After adjustment for age, sex, donor source, conditioning therapy and year of transplant, overweight patients were significantly less likely to survive than ideal-weight patients (hazard ratio (HR) 1.91; 95% confidence interval, 1.10-3.31). There was no significant increase in mortality when underweight patients were compared with ideal-weight patients (HR 1.47; 95% confidence interval, 0.57-3.79).


CONCLUSIONS
Children who are overweight before hematopoietic stem cell transplantation have decreased survival compared with ideal-weight children.
Department of Nutrition and Dietetics, Royal Children's Hospital, Herston, Queensland, Australia. Melinda_White@health.qld.gov.au
M
M
White
A J
AJ
Murphy
A
A
Hallahan
R S
RS
Ware
C
C
Fraser
P S W
PS
Davies
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality; D006776:Hospitals, Pediatric; D006801:Humans; D056865:Ideal Body Weight; D008297:Male; D008499:Medical Records; D009369:Neoplasms / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D009517:New South Wales / Q000453:epidemiology; D050177:Overweight / Q000150:complications*; D011793:Queensland / Q000453:epidemiology; D012189:Retrospective Studies; D012727:Sex Characteristics; D016019:Survival Analysis; D013851:Thinness / Q000150:complications*