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Effect of body mass in children with hematologic malignancies undergoing allogeneic bone marrow transplantation.
- Aplenc, Richard (author)
- Zhang, Mei-Jie (author)
- Sung, Lillian (author)
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- Zhu, Xiaochun (author)
- Ho, Vincent T (author)
- Cooke, Kenneth (author)
- Dvorak, Christopher (author)
- Hale, Gregory (author)
- Isola, Luis M (author)
- Lazarus, Hillard M (author)
- McCarthy, Philip L (author)
- Pulsipher, Michael (author)
- Pasquini, Marcelo C (author)
- Bunin, Nancy (author)
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- (creator_code:org_t)
- American Society of Hematology, 2014
- 2014
- English.
- In: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 123:22, s. 3504-11
- Journal article (peer-reviewed)
Abstract
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- The rising incidence of pediatric obesity may significantly affect bone marrow transplantation (BMT) outcomes. We analyzed outcomes in 3687 children worldwide who received cyclophosphamide-based BMT regimens for leukemias between 1990 and 2007. Recipients were classified according to age-adjusted body mass index (BMI) percentiles as underweight (UW), at risk of UW (RUW), normal, overweight (OW), or obese (OB). Median age and race were similar in all groups. Sixty-one percent of OB children were from the United States/Canada. Three-year relapse-free and overall survival ranged from 48% to 52% (P = .54) and 55% to 58% (P = .81) across BMI groups. Three-year leukemia relapses were 33%, 33%, 29%, 25%, and 21% in the UW, RUW, normal, OW, and OB groups, respectively (P < .001). Corresponding cumulative incidences for transplant-related mortality (TRM) were 18%, 19%, 21%, 22%, and 28% (P < .01). Multivariate analysis demonstrated a decreased risk of relapse compared with normal BMI (relative risk [RR] = 0.73; P < .01) and a trend toward higher TRM (RR = 1.28; P = .014). BMI in children is not significantly associated with different survival after BMT for hematologic malignancies. Obese children experience less relapse posttransplant compared with children with normal BMI; however, this benefit is offset by excess in TRM.
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- Aplenc, Richard
- Zhang, Mei-Jie
- Sung, Lillian
- Zhu, Xiaochun
- Ho, Vincent T
- Cooke, Kenneth
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- Dvorak, Christop ...
- Hale, Gregory
- Isola, Luis M
- Lazarus, Hillard ...
- McCarthy, Philip ...
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- Pulsipher, Micha ...
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- Bunin, Nancy
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- Uppsala University
- Karolinska Institutet
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