Effect of body mass in children with hematologic malignancies undergoing allogeneic bone marrow transplantation.

TitleEffect of body mass in children with hematologic malignancies undergoing allogeneic bone marrow transplantation.
Publication TypeJournal Article
Year of Publication2014
AuthorsAplenc 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 AuthorsRegimen-Related Toxicity Working Committee, Center for International Blood and Marrow Transplant Research
JournalBlood
Volume123
Issue22
Pagination3504-11
Date Published2014 May 29
ISSN1528-0020
KeywordsAdolescent, 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.

DOI10.1182/blood-2013-03-490334
Alternate JournalBlood
PubMed ID24711663
PubMed Central IDPMC4041168
Grant List5U10HL069294 / 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