Effect of body mass in children with hematologic malignancies undergoing allogeneic bone marrow transplantation. Blood 2014 May 29;123(22):3504-11
Date
04/09/2014Pubmed ID
24711663Pubmed Central ID
PMC4041168DOI
10.1182/blood-2013-03-490334Scopus ID
2-s2.0-84901721624 (requires institutional sign-in at Scopus site) 30 CitationsAbstract
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.
Author List
Aplenc R, Zhang MJ, Sung L, Zhu X, Ho VT, Cooke K, Dvorak C, Hale G, Isola LM, Lazarus HM, McCarthy PL, Olsson R, Pulsipher M, Pasquini MC, Bunin N, Regimen-Related Toxicity Working Committee, Center for International Blood and Marrow Transplant ResearchAuthors
Marcelo C. Pasquini MD, MS Professor in the Medicine department at Medical College of WisconsinMei-Jie Zhang PhD Professor in the Institute for Health and Equity department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentAntineoplastic Combined Chemotherapy Protocols
Body Mass Index
Body Weight
Bone Marrow Transplantation
Canada
Cause of Death
Child
Child, Preschool
Female
Hematologic Neoplasms
Humans
Male
Pediatric Obesity
Recurrence
Transplantation, Homologous
Treatment Outcome
United States
