Effect of body mass index on mortality of patients with lymphoma undergoing autologous hematopoietic cell transplantation. Biol Blood Marrow Transplant 2006 May;12(5):541-51
Date
04/26/2006Pubmed ID
16635789DOI
10.1016/j.bbmt.2005.12.033Scopus ID
2-s2.0-33745461684 (requires institutional sign-in at Scopus site) 76 CitationsAbstract
High-dose therapy with autologous hematopoietic cell transplantation (auto-HCT) is frequently used to improve outcomes in lymphoma. However, small studies suggest a survival disadvantage among obese patients. Using a retrospective cohort analysis, we studied the outcomes of 4681 patients undergoing auto-HCT for Hodgkin or non-Hodgkin lymphoma between 1990 and 2000 according to body mass index (BMI). Four groups categorized by BMI were compared by using Cox proportional hazards regression to adjust for other prognostic factors. A total of 1909 patients were categorized as normal weight (BMI 18-25 kg/m2), 121 as underweight (BMI<18 kg/m2), 1725 as overweight (BMI>25-30 kg/m2), and 926 as obese (BMI>30 kg/m2) at the time of HCT. Outcomes evaluated included overall survival, relapse, transplantation-related mortality (TRM), and lymphoma-free survival. TRM was similar among the normal, overweight, and obese groups; the underweight group had a higher risk of TRM (relative risk [RR], 2.46; 95% confidence interval [CI], 1.59-3.82; P<0.0001) compared with the normal-BMI group. No differences in relapse were noted. Overall mortality was higher in the underweight group (RR, 1.48; 95% CI, 1.17-1.88; P=.001) and lower in the overweight (RR, 0.87; 95% CI, 0.79-0.96; P=.004) and obese (RR, 0.76; 95% CI, 0.67-0.86; P<.0001) groups compared with the normal-BMI group. In light of our inability to find differences in survival among overweight, obese, and normal-weight patients, obesity alone should not be viewed as a contraindication to proceeding with auto-HCT for lymphoma when it is otherwise indicated.
Author List
Navarro WH, Loberiza FR Jr, Bajorunaite R, van Besien K, Vose JM, Lazarus HM, Rizzo JDAuthors
Ruta Brazauskas PhD Associate Professor in the Institute for Health and Equity department at Medical College of WisconsinJ. Douglas Rizzo MD, MS Director, Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Antineoplastic Combined Chemotherapy Protocols
Body Mass Index
Bone Marrow Purging
Combined Modality Therapy
Disease-Free Survival
Female
Hematopoietic Stem Cell Transplantation
Humans
Life Tables
Lymphoma
Male
Middle Aged
Obesity
Overweight
Proportional Hazards Models
Recurrence
Registries
Retrospective Studies
Survival Analysis
Thinness
Transplantation Conditioning
Transplantation, Autologous
Treatment Outcome
