The role of body mass index and other body composition parameters in early post-transplant complications in patients undergoing allogeneic stem cell transplantation with busulfan–cyclophosphamide conditioning

Abstract

Patients with impaired nutritional status may show increased risk of hematopoietic stem cell transplantation (HSCT)-related complications. This study was conducted to determine whether body mass index (BMI) and other body composition parameters, such as lean body mass index (LBMI) and body fat mass (BFM), are associated with early post-transplantation toxicity and mortality in allogeneic HSCT recipients. The records of 71 patients diagnosed with acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), chronic myeloid leukemia (CML), or myelodysplastic leukemia (MDS) who had undergone allogeneic HSCT with a conditioning regimen of busulfan-cyclophosphamide (Bu-Cy), between September 2003 and January 2009 at the Stem Cell Transplantation Unit of Gazi University Hospital were retrospectively evaluated. BMI was found to be negatively correlated with the NCI grade of mucositis, cardiotoxicity, emesis, and hyperglycemia, and with the number of erythrocyte transfusions. LBMI was also negatively correlated with the number of erythrocyte transfusions, cardiotoxicity, emesis, and hyperglycemia. BFM was negatively correlated with the day of neutrophil engraftment, and NCI grade of mucositis. Nutritional status did not have an impact on overall survival (OS), progression-free survival (PFS), or 100-day transplant related mortality (TRM).

Pre-transplant arm muscle area: a simple measure to identify patients at risk

“…When BMI is used to determine nutritional status, the results are contradictory. Le Blanc [30] found that pre-HSCT BMI was related to mortality; however, Hadjibabaie [4] and Sucak [5] did not observe the same. In the case of our study, the association between pretransplant nutritional status and mortality, established by BMI, was also not present.…”

“…Among them, the most frequent are mucositis, constipation or diarrhea, immunological reactions, infectious complications and graft versus host disease [4][5][6].…”

Impact of being overweight on outcomes of hematopoietic SCT: a meta-analysis

“…6,7,9,[14][15][16][17][18][19][20][21]25,27,28 The definition of significant aGVHD was as follows: grade III-IV in three studies, 7,9,18 and grade II-IV in the remaining studies.…”

The impact of pre-transplant body weight on short- and long-term outcomes after allogeneic hematopoietic cell transplantation in adults using different weight classification tools

“…Most working groups have applied similar but slightly different body mass index (BMI) classifications according to the World Health Organization (WHO BMI) and the remainder employed very different cutoff values from the ratio of actual to ideal body weight (IBW). [1][2][3][4][5][6][7][8][9][10][11] Furthermore, the follow-up period for outcomes considered in one part of the studies covered at most the first post transplant year. 3,6,9,10 This therefore reveals the strengths of the present retrospective analysis, as we investigated for the first time the validity of three different weight classification tools using standard cutoffs as pretransplant prognostic factors, a long follow-up period of 7.2 years and a consistent chemotherapy dose adjustment in obese patients (Table 1) compared with most other studies with no adjustment or relevant information.…”

“…2,6,10,11,14 However, other studies detected no association between obesity and OS. 1,2,[4][5][6][7]9 A recent metaanalysis by Nakao et al 13 focused on the overweight impact on HCT outcomes. By pooling pediatric and adult allo-HCT studies, overweight at transplantation was associated with worse OS and a higher aGvHD rate.…”