Title | Effect of body mass in children with hematologic malignancies undergoing allogeneic bone marrow transplantation. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Aplenc R, Zhang M-J, Sung L, Zhu X, Ho VT, Cooke K, Dvorak C, Hale G, Isola LM, Lazarus HM, McCarthy PL, Olsson R, Pulsipher MA, Pasquini MC, Bunin N |
Corporate Authors | Regimen-Related Toxicity Working Committee, Center for International Blood and Marrow Transplant Research |
Journal | Blood |
Volume | 123 |
Issue | 22 |
Pagination | 3504-11 |
Date Published | 2014 May 29 |
ISSN | 1528-0020 |
Keywords | Adolescent, Antineoplastic 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 |
Abstract | 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. |
DOI | 10.1182/blood-2013-03-490334 |
Alternate Journal | Blood |
PubMed ID | 24711663 |
PubMed Central ID | PMC4041168 |
Grant List | 5U10HL069294 / HL / NHLBI NIH HHS / United States HHSH250201200016C / / PHS HHS / United States P30 CA016520 / CA / NCI NIH HHS / United States U24 CA076518 / CA / NCI NIH HHS / United States U24-CA076518 / CA / NCI NIH HHS / United States |