Faculty Collaboration Database

Does recipient body mass index inform donor selection for allogeneic haematopoietic cell transplantation? Br J Haematol 2022 May;197(3):326-338

Date

03/15/2022

Pubmed ID

35286719

Pubmed Central ID

PMC9675037

DOI

10.1111/bjh.18108

Scopus ID

2-s2.0-85126235994 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

It is not known whether obesity has a differential effect on allogeneic haematopoietic cell transplantation outcomes with alternative donor types. We report the results of a retrospective registry study examining the effect of obesity [body mass index (BMI) > 30] on outcomes with alternative donors (haploidentical related donor with two or more mismatches and receiving post-transplant cyclophosphamide [haplo] and cord blood (CBU)] versus matched unrelated donor (MUD). Adult patients receiving haematopoietic cell transplantation for haematologic malignancy (2013-2017) (N = 16 182) using MUD (n = 11 801), haplo (n = 2894) and CBU (n = 1487) were included. The primary outcome was non-relapse mortality (NRM). The analysis demonstrated a significant, non-linear interaction between pretransplant BMI and the three donor groups for NRM: NRM risk was significantly higher with CBU compared to haplo at BMI 25-30 [hazard ratio (HR) 1.66-1.71, p < 0.05] and MUD transplants at a BMI of 25-45 (HR, 1.61-3.47, p < 0.05). The results demonstrated that NRM and survival outcomes are worse in overweight and obese transplant recipients (BMI ≥ 25) with one alternative donor type over MUD, although obesity does not appear to confer a uniform differential mortality risk with one donor type over the other. BMI may serve as a criterion for selecting a donor among the three (MUD, haplo and CBU) options, if matched sibling donor is not available.

Author List

Abou-Ismail MY, Fraser R, Allbee-Johnson M, Metheny L 3rd, Ravi G, Ahn KW, Bhatt NS, Lazarus HM, de Lima M, El Jurdy N, Hematti P, Beitinjaneh AM, Nishihori T, Badawy SM, Sharma A, Pasquini MC, Savani BN, Sorror ML, Stadtmauer EA, Chhabra S

Authors

Kwang Woo Ahn PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
Raphael Fraser PhD Assistant Professor in the Medicine department at Medical College of Wisconsin
Peiman Hematti MD Professor in the Medicine department at Medical College of Wisconsin
Marcelo C. Pasquini MD, MS Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Body Mass Index
Donor Selection
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Neoplasm Recurrence, Local
Obesity
Retrospective Studies
Unrelated Donors