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Childhood obesity and outcomes after bone marrow transplantation for patients with severe aplastic anemia. Biol Blood Marrow Transplant 2011 May;17(5):737-44

Date

09/08/2010

Pubmed ID

20817111

Pubmed Central ID

PMC3035737

DOI

10.1016/j.bbmt.2010.08.019

Scopus ID

2-s2.0-79954570682   19 Citations

Abstract

The prevalence of obesity in the pediatric population has increased in the last 2 decades and represents a serious health concern, with potential impact on outcomes of hematopoietic cell transplantation (HCT). We studied the effect of weight by age-adjusted body mass index (BMI) percentile in 1,281 pediatric patients (age 2-19 years) with severe aplastic anemia who underwent HCT between 1990 and 2005. The study population was divided into 5 weight groups-underweight, risk of underweight, normal BMI range, risk of overweight, and overweight-according to age-adjusted BMI percentiles. Cox proportional hazards regression models for survival and acute graft-versus-host disease (aGVHD), performed using weight groups as the main effect and the normal BMI range (26th-75th percentile) as the baseline comparison, found higher mortality among overweight children (>95th percentile adjusted for age). Weight at transplantation did not increase the adjusted risk of grade III-IV aGVHD. The 1-year and 2-year overall survival rates were 60% and 59% for overweight children, compared with >70% in children with lower BMI at both time points (P < .001). Other significant factors associated with survival included race and region, donor type, conditioning regimens in related donor transplants, performance score, and year of transplantation. In conclusion, overweight children with aplastic anemia have worse outcomes after HCT. The impact of obesity on survival outcomes in children should be discussed during pretransplantation counseling.

Author List

Barker CC, Agovi MA, Logan B, Lazarus HM, Ballen KK, Gupta V, Hale GA, Frangoul H, Ho V, Rizzo JD, Pasquini MC, Regimen-Related Toxicity Writing Committee, Center for International Blood and Marrow Transplant Research

Authors

Marcelo C. Pasquini MD, MS Professor in the Medicine department at Medical College of Wisconsin
J. Douglas D. 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

Adolescent
Anemia, Aplastic
Body Mass Index
Bone Marrow Transplantation
Child
Child, Preschool
Continental Population Groups
Female
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Humans
Male
Multivariate Analysis
Obesity
Retrospective Studies
Severity of Illness Index
Survival Rate
Thinness
Treatment Outcome
Young Adult
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a