Body mass index does not impact hematopoietic progenitor cell mobilization for autologous hematopoietic cell transplantation

Abstract

Background Obesity has implications for hematopoietic progenitor cell (HPC) mobilization, chemotherapy administration, and medication dosing. We analyzed the impact of obesity on HPC mobilization as well as key outcomes that are associated with cell dose in autologous hematopoietic cell transplantation (AHCT) recipients. Methods We conducted a retrospective cohort study on 556 consecutive eligible AHCT recipients at our institution from 1/2004 to 12/2009. Patients were categorized into four groups based on the body mass index (BMI): underweight (BMI < 18.5), normal (18.5‐24.9), overweight (25.0‐29.9), or obese (≥30.0). Primary endpoints of interest included HPC mobilization, neutrophil and platelet recovery, hospital stay and survival. Results The diagnoses were mostly non‐Hodgkin lymphoma, multiple myeloma, and Hodgkin lymphoma. The majority of the patients had received three or less prior chemotherapy regimens and had not received prior radiation therapy. Most patients had chemosensitive disease at time of transplant. For HPC mobilization regimen, 68% received chemotherapy and G‐CSF, 32% received G‐CSF alone. Busuflan/etoposide/cyclophosphamide, melphalan, and busulfan/cyclophosphamide were used for conditioning. Obesity did not correlate with HPC mobilization and had no association with neutrophil or platelet recovery, or length of transplant hospitalization. On multivariable analysis, obese patients demonstrated better survival than those who were not obese. Conclusion Obese AHCT recipients had similar rates of HPC mobilization, neutrophil and platelet engraftment and length of transplant hospitalization, and experienced better survival compared with recipients with lower BMI. High BMI by itself should not be considered as a contraindication to AHCT.

Correlation of Body Mass Index and Proinflammatory Cytokine Levels with Hematopoietic Stem Cell Mobilization

“…Several factors such as gender, cholinesterase, platelet count, red cell count, and mean corpuscular volume are associated with HSC mobilization [ 19 , 23 , 37 , 38 ]. Although the correlation between BMI and HSC mobilization has been reported [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 39 , 40 ], some contradictions arise. For example, some researchers claimed that BMI has no influence on HSC mobilization [ 39 , 40 ], and others reported the opposite results [ 17 , 18 , 19 , 20 , 21 , 22 , 23 ].…”

“…Although the correlation between BMI and HSC mobilization has been reported [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 39 , 40 ], some contradictions arise. For example, some researchers claimed that BMI has no influence on HSC mobilization [ 39 , 40 ], and others reported the opposite results [ 17 , 18 , 19 , 20 , 21 , 22 , 23 ]. This phenomenon indicates that the association between BMI and HSC mobilization remains to be elucidated.…”

“…Although the correlation between BMI and HSC mobilization has been reported [17][18][19][20][21][22][23]39,40], some contradictions arise. For example, some researchers claimed that BMI has no influence on HSC mobilization [39,40], and others reported the opposite results [17][18][19][20][21][22][23]. This…”

Body mass index-associated responses to an ABVD-like regimen in newly-diagnosed patients with Hodgkin lymphoma

“…Moreover, different populations exhibit different clinical responses to ABVD-like chemotherapy regimens ( Wen et al, 2022 ). Among them, obese people have implications for chemotherapy administration and dosing ( Khouri et al, 2019 ).…”