Impact of obesity on allogeneic stem cell transplant patients: A matched case-controlled study

Fleming, Donald R.; Rayens, Mary Kay; Garrison, Juanita

doi:10.1016/s0002-9343(96)00450-0

Cited by 58 publications

(52 citation statements)

References 10 publications

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“…6 Three studies in adult HSCT have shown that obesity causes decreased survival as a result of increased treatment-related mortality and relapse. [16][17][18] One of these studies incorporated a subset of 67 pediatric patients and found no relationship between survival and weight. 16 Explanations of why overweight children have decreased survival post-HSCT are inconclusive as there is a lack of cohesive and comprehensive literature in this area.…”

Section: Discussionmentioning

confidence: 99%

“…[16][17][18] One of these studies incorporated a subset of 67 pediatric patients and found no relationship between survival and weight. 16 Explanations of why overweight children have decreased survival post-HSCT are inconclusive as there is a lack of cohesive and comprehensive literature in this area. One theory is that altered drug deposition may occur in obese patients.…”

Section: Discussionmentioning

confidence: 99%

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Survival in overweight and underweight children undergoing hematopoietic stem cell transplantation

et al. 2012

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Survival in overweight and underweight children undergoing hematopoietic stem cell transplantation

et al. 2012

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“…5,6 Furthermore, under-and overweight patients are at an increased risk for complications, non-relapse mortality and overall survival after alloHCT. [7][8][9][10] To date, few studies have assessed nutritional status before alloHCT, and most of them only recorded body mass index (BMI) as a potential risk factor for survival. [7][8][9][10] Except for one report by Kyle et al 11 on the development of lean body mass, there were until now no longitudinal data on nutritional status and body composition in the early post-transplant period, although several reports showed that depletion of micronutrients, mainly vitamin D, is common before and after alloHCT.…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9][10] To date, few studies have assessed nutritional status before alloHCT, and most of them only recorded body mass index (BMI) as a potential risk factor for survival. [7][8][9][10] Except for one report by Kyle et al 11 on the development of lean body mass, there were until now no longitudinal data on nutritional status and body composition in the early post-transplant period, although several reports showed that depletion of micronutrients, mainly vitamin D, is common before and after alloHCT. [12][13][14] There are now many nutritional parameters available and validated for cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal follow-up of nutritional status and its influencing factors in adults undergoing allogeneic hematopoietic cell transplantation

Urbain

Birlinger

Lambert

et al. 2012

Bone Marrow Transplant

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There are few longitudinal data on nutritional status and body composition of patients undergoing allogeneic hematopoietic cell transplantation (alloHCT). We assessed nutritional status of 105 patients before alloHCT and its course during the early posttransplant period to day þ 30 and day þ 100 via weight history, body mass index (BMI) normalized for gender and age, Subjective Global Assessment, phase angle normalized for gender, age, and BMI, and fat-free and body fat masses. Furthermore, we present a multivariate regression model investigating the impact of factors on body weight. At admission, 23.8% reported significant weight losses (45%) in the previous 6 months, and we noted 31.5% with abnormal age-and sex-adjusted BMI values (p10th, X90th percentiles). BMI decreased significantly (Po0.0001) in both periods by 11% in total, meaning a weight loss of 8.6 ± 5.7 kg. Simultaneously, the patients experienced significant losses (Po0.0001) of both fat-free and body fat masses. Multivariate regression model revealed clinically relevant acute GVHD (parameter estimate 1.43; P ¼ 0.02) and moderate/severe anorexia (parameter estimate 1.07; P ¼ 0.058) as independent factors influencing early weight loss. In conclusion, our results show a significant deterioration in nutritional status during the early post-transplant period. Predominant alloHCT-associated complications such as anorexia and acute GVHD became evident as significant factors influencing nutritional status.

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“…7 Several authors have hypothesized that severely overweight patients are at increased risk of transplant-related toxicity and mortality, but weight has not been yet considered as a proven risk factor in the setting of the transplant procedure. [8][9][10] Obese individuals have altered pharmacokinetics for many medications when compared with the non-obese. Many drugs are relatively lipid insoluble and, therefore, distribute poorly into adipose tissue; obese patients tend to have a greater proportion of fat to total body weight than do non-obese patients.…”

mentioning

confidence: 99%

Obesity and autologous stem cell transplantation in acute myeloid leukemia

Meloni

Proia

Capria

et al. 2001

Bone Marrow Transplant

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Summary:In the bone marrow transplant setting, several authors hypothesized that severely overweight patients are at increased risk of transplant-related toxicity, but different definitions of obesity, different body weight groupings and heterogeneous samples of patients were analyzed. To overcome these limitations, we retrospectively considered a homogeneous group of 54 patients (median age 36.5 years), with a diagnosis of de novo acute myeloid leukemia (AML), autografted in first complete remission (CR) with the Bu-Cy2 conditioning regimen, dosed on actual body weight. Patients were classified into three groups (obese, non-obese, underweight) using body mass index (BMI = kg/m 2 ); for each group we analyzed transplant-related toxicity and mortality, overall survival and disease-free survival (OS/DFS). In spite of the relatively small number of patients, in our results high BMI appears a predictive factor for an increase of treatment-related toxicity and mortality. Moreover, 30 (55%) patients are currently alive in continuous CR, and after a median follow-up of 76.5 months (range 14-137) statistically significant differences in OS and DFS were detected between obese and non-obese groups (P = 0.012 and 0.021, respectively). Our study sugggests that obesity may represent an independent risk factor for autograft in AML and further investigations are warranted. Bone Marrow Transplantation (2001) 28, [365][366][367]

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Impact of obesity on allogeneic stem cell transplant patients: A matched case-controlled study

Cited by 58 publications

References 10 publications

Survival in overweight and underweight children undergoing hematopoietic stem cell transplantation

Survival in overweight and underweight children undergoing hematopoietic stem cell transplantation

Longitudinal follow-up of nutritional status and its influencing factors in adults undergoing allogeneic hematopoietic cell transplantation

Obesity and autologous stem cell transplantation in acute myeloid leukemia

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