Faculty Collaboration Database

Impact of Obesity on Clinical Outcomes of Elderly Patients Undergoing Allogeneic Hematopoietic Cell Transplantation for Myeloid Malignancies. Biol Blood Marrow Transplant 2019 Jan;25(1):e33-e38

Date

09/24/2018

Pubmed ID

30244105

DOI

10.1016/j.bbmt.2018.08.031

Scopus ID

2-s2.0-85055445894 (requires institutional sign-in at Scopus site)   10 Citations

Abstract

Allogeneic hematopoietic cell transplantation (allo-HCT) is a high-risk treatment option for patients with hematologic malignancies. Advanced age and obesity can impact outcomes after allo-HCT. Previous registry studies of all age groups found that obesity does not affect outcomes. However, obesity can accelerate age-related decline in physical function and exacerbate comorbid conditions in older patients. Studies evaluating the effect of obesity on elderly patients undergoing allo-HCT are lacking. We performed a retrospective analysis of 86 nonobese (body mass index [BMI] <30) and obese (BMI ≥30) patients age ≥60 years who underwent allo-HCT for myeloid malignancies between January 2010 and June 2015. We found no significant between-group differences in mean age, sex, comorbid conditions, cytogenetic risk, disease indication for transplantation, or donor type. The median overall survival (OS) was 36 months for the BMI <30 group and 24 months for the BMI ≥30 group (P = .55). The median progression-free survival (PFS) was 10.1 months in the BMI <30 group and 13.6 months in the BMI ≥30 group (P = .93). There were no significant between-group differences in acute graft-versus-host disease (GVHD) and cumulative incidence of chronic GVHD at 1 year post-transplantation. Among patients admitted for transplantation, the mean length of stay was 25 days in the BMI <30 group and 26 days in the BMI ≥30 group (P = .64). The rate of readmission within 30 days of discharge was significantly higher in the BMI ≥30 group (34% versus 16%; P = .045). Our data reveal that in these elderly patients with myeloid malignancies undergoing allo-HCT, clinical outcomes, including OS, PFS, and GVHD, were not affected by obesity. Thus, in elderly patients, obesity should not preclude consideration for curative allo-HCT and does not portend worse outcomes after allo-HCT.

Author List

Voshtina E, Szabo A, Hamadani M, Fenske TS, D'Souza A, Chhabra S, Saber W, Drobyski WR, Hari P, Shah NN

Authors

Anita D'Souza MD Associate Professor in the Medicine department at Medical College of Wisconsin
William R. Drobyski MD Professor in the Medicine department at Medical College of Wisconsin
Timothy Fenske MD Professor in the Medicine department at Medical College of Wisconsin
Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of Wisconsin
Parameswaran Hari MD Adjunct Professor in the Medicine department at Medical College of Wisconsin
Wael Saber MD, MS Professor in the Medicine department at Medical College of Wisconsin
Nirav N. Shah MD Associate Professor in the Medicine department at Medical College of Wisconsin
Aniko Szabo 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

Aged
Allografts
Disease-Free Survival
Female
Hematologic Neoplasms
Hematopoietic Stem Cell Transplantation
Humans
Leukemia, Myeloid, Acute
Male
Middle Aged
Myelodysplastic Syndromes
Obesity
Primary Myelofibrosis
Retrospective Studies
Survival Rate