title: Baseline body mass index among children and adults undergoing allogeneic hematopoietic cell transplantation: clinical characteristics and outcomes.
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.
authors.affiliation: University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA.
authors.forename: M
authors.initials: M
authors.lastname: Gleimer
authors.affiliation: Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Li
authors.affiliation: Division of Pediatric Hematology/Oncology, Blood and Marrow Transplantation Program, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA.
authors.forename: L
authors.initials: L
authors.lastname: Chang
authors.affiliation: Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: S
authors.initials: S
authors.lastname: Paczesny
authors.affiliation: 1] Division of General Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA [2] Informatics Core of the Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Hanauer
authors.affiliation: College of Pharmacy, University of Michigan, Ann Arbor, MI, USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Frame
authors.affiliation: Division of Pediatric Hematology/Oncology, Blood and Marrow Transplantation Program, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Byersdorfer
authors.affiliation: Division of Hematology/Oncology, Blood and Marrow Transplantation Program, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
authors.forename: P R
authors.initials: PR
authors.lastname: Reddy
authors.affiliation: Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA.
authors.forename: T M
authors.initials: TM
authors.lastname: Braun
authors.affiliation: Division of Pediatric Hematology/Oncology, Blood and Marrow Transplantation Program, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA.
authors.forename: S W
authors.initials: SW
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D000368:Aged; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult