Relationship of Body Mass Index and Arm Anthropometry to Outcomes after Pediatric Allogeneic Hematopoietic Cell Transplantation for Hematologic Malignancies
Abstract Although nutritional status may adversely affect various health outcomes, the relationship between anthropometry and outcomes after hematopoietic cell transplantation (HCT) has not been fully studied in children. We analyzed the impact of pre-HCT body mass index (BMI), arm muscle area, and...
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| Veröffentlicht in: | Biology of blood and marrow transplantation 2013-07, Vol.19 (7), p.1081-1086 |
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| creator | Hoffmeister, Paul A Storer, Barry E Macris, Paula Charuhas Carpenter, Paul A Baker, K. Scott |
| description | Abstract Although nutritional status may adversely affect various health outcomes, the relationship between anthropometry and outcomes after hematopoietic cell transplantation (HCT) has not been fully studied in children. We analyzed the impact of pre-HCT body mass index (BMI), arm muscle area, and arm fat area on outcomes in 733 patients age 2-18 years who underwent allogeneic HCT for a hematologic malignancy between 1985 and 2009. We evaluated these 3 variables according to patient group based on age- and sex-adjusted percentiles for BMI, arm muscle area ( |
| doi_str_mv | 10.1016/j.bbmt.2013.04.017 |
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Scott</creator><creatorcontrib>Hoffmeister, Paul A ; Storer, Barry E ; Macris, Paula Charuhas ; Carpenter, Paul A ; Baker, K. Scott</creatorcontrib><description><![CDATA[Abstract Although nutritional status may adversely affect various health outcomes, the relationship between anthropometry and outcomes after hematopoietic cell transplantation (HCT) has not been fully studied in children. We analyzed the impact of pre-HCT body mass index (BMI), arm muscle area, and arm fat area on outcomes in 733 patients age 2-18 years who underwent allogeneic HCT for a hematologic malignancy between 1985 and 2009. We evaluated these 3 variables according to patient group based on age- and sex-adjusted percentiles for BMI, arm muscle area (<5th, 5th-24th, 25th-94th, and ≥95th), and arm fat area (<25th, 25th-94th, and ≥95th). Cox proportional hazards regression models for event-free survival (EFS), relapse, and nonrelapse mortality (NRM) at 100 days and 3 years after HCT, as well as grade II-IV acute graft-versus-host disease (GVHD) and chronic GVHD, were performed using the 3 major variables and adjusted for covariates. BMI was <5th percentile in only 3% of patients and ≥95th percentile in 15% of patients, but outcomes for both groups were similar to those for the BMI 25th-94th percentile group. The BMI 5th-24th percentile group had lower EFS ( P = .01) and higher relapse ( P = .003) at day +100 post-HCT, but these associations did not hold at 3 years post-HCT. Arm muscle area was <5th percentile in 8% of patients, and arm fat area was <25th percentile in 10%. Analysis of arm muscle area showed that the <5th percentile group had lower EFS and higher NRM and relapse rate at day +100 ( P = .002, .04, and .01, respectively) and 3 years ( P = .0004, .008, and .01, respectively) post-HCT. Arm fat area <25th percentile was associated with lower EFS at day +100 (hazard ratio, 1.5; P = .05), but not at 3 years post-HCT. Anthropometry variables were not associated with acute or chronic GVHD. In conclusion, arm muscle area <5th percentile appears to be a stronger predictor than BMI of poor outcomes after HCT in children with hematologic malignancies.]]></description><identifier>ISSN: 1083-8791</identifier><identifier>EISSN: 1523-6536</identifier><identifier>DOI: 10.1016/j.bbmt.2013.04.017</identifier><identifier>PMID: 23623893</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Acute Disease ; Adolescent ; Anthropometry ; Antineoplastic Agents - therapeutic use ; Arm - anatomy & histology ; Arm anthropometry ; Body Mass Index ; Child ; Child, Preschool ; Children ; Chronic Disease ; Female ; Graft vs Host Disease - diagnosis ; Graft vs Host Disease - pathology ; Graft vs Host Disease - therapy ; Hematologic malignancy ; Hematologic Neoplasms - diagnosis ; Hematologic Neoplasms - pathology ; Hematologic Neoplasms - therapy ; Hematology, Oncology and Palliative Medicine ; Hematopoietic cell transplantation ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Muscle, Skeletal - anatomy & histology ; Proportional Hazards Models ; Retrospective Studies ; Subcutaneous Fat - anatomy & histology ; Survival Analysis ; Transplantation Conditioning ; Transplantation, Homologous ; Treatment Outcome</subject><ispartof>Biology of blood and marrow transplantation, 2013-07, Vol.19 (7), p.1081-1086</ispartof><rights>American Society for Blood and Marrow Transplantation</rights><rights>2013 American Society for Blood and Marrow Transplantation</rights><rights>Copyright © 2013 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-b8812df5406bb23ca07ae76eda491a49b7400c273fa08744e67bb41ba6dd84e13</citedby><cites>FETCH-LOGICAL-c455t-b8812df5406bb23ca07ae76eda491a49b7400c273fa08744e67bb41ba6dd84e13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1083879113001857$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23623893$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hoffmeister, Paul A</creatorcontrib><creatorcontrib>Storer, Barry E</creatorcontrib><creatorcontrib>Macris, Paula Charuhas</creatorcontrib><creatorcontrib>Carpenter, Paul A</creatorcontrib><creatorcontrib>Baker, K. Scott</creatorcontrib><title>Relationship of Body Mass Index and Arm Anthropometry to Outcomes after Pediatric Allogeneic Hematopoietic Cell Transplantation for Hematologic Malignancies</title><title>Biology of blood and marrow transplantation</title><addtitle>Biol Blood Marrow Transplant</addtitle><description><![CDATA[Abstract Although nutritional status may adversely affect various health outcomes, the relationship between anthropometry and outcomes after hematopoietic cell transplantation (HCT) has not been fully studied in children. We analyzed the impact of pre-HCT body mass index (BMI), arm muscle area, and arm fat area on outcomes in 733 patients age 2-18 years who underwent allogeneic HCT for a hematologic malignancy between 1985 and 2009. We evaluated these 3 variables according to patient group based on age- and sex-adjusted percentiles for BMI, arm muscle area (<5th, 5th-24th, 25th-94th, and ≥95th), and arm fat area (<25th, 25th-94th, and ≥95th). Cox proportional hazards regression models for event-free survival (EFS), relapse, and nonrelapse mortality (NRM) at 100 days and 3 years after HCT, as well as grade II-IV acute graft-versus-host disease (GVHD) and chronic GVHD, were performed using the 3 major variables and adjusted for covariates. BMI was <5th percentile in only 3% of patients and ≥95th percentile in 15% of patients, but outcomes for both groups were similar to those for the BMI 25th-94th percentile group. The BMI 5th-24th percentile group had lower EFS ( P = .01) and higher relapse ( P = .003) at day +100 post-HCT, but these associations did not hold at 3 years post-HCT. Arm muscle area was <5th percentile in 8% of patients, and arm fat area was <25th percentile in 10%. Analysis of arm muscle area showed that the <5th percentile group had lower EFS and higher NRM and relapse rate at day +100 ( P = .002, .04, and .01, respectively) and 3 years ( P = .0004, .008, and .01, respectively) post-HCT. Arm fat area <25th percentile was associated with lower EFS at day +100 (hazard ratio, 1.5; P = .05), but not at 3 years post-HCT. Anthropometry variables were not associated with acute or chronic GVHD. In conclusion, arm muscle area <5th percentile appears to be a stronger predictor than BMI of poor outcomes after HCT in children with hematologic malignancies.]]></description><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Anthropometry</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Arm - anatomy & histology</subject><subject>Arm anthropometry</subject><subject>Body Mass Index</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Chronic Disease</subject><subject>Female</subject><subject>Graft vs Host Disease - diagnosis</subject><subject>Graft vs Host Disease - pathology</subject><subject>Graft vs Host Disease - therapy</subject><subject>Hematologic malignancy</subject><subject>Hematologic Neoplasms - diagnosis</subject><subject>Hematologic Neoplasms - pathology</subject><subject>Hematologic Neoplasms - therapy</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Hematopoietic cell transplantation</subject><subject>Hematopoietic Stem Cell Transplantation</subject><subject>Humans</subject><subject>Male</subject><subject>Muscle, Skeletal - anatomy & histology</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Subcutaneous Fat - anatomy & histology</subject><subject>Survival Analysis</subject><subject>Transplantation Conditioning</subject><subject>Transplantation, Homologous</subject><subject>Treatment Outcome</subject><issn>1083-8791</issn><issn>1523-6536</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ksFu1DAQhiMEoqXwAhyQj1wS7NiJEwkhLStKK7UqgnK2HHvSenHsYDuo-y48LA67cODAwfKM9P1jz_xTFC8Jrggm7ZtdNQxTqmpMaIVZhQl_VJySpqZl29D2cY5xR8uO9-SkeBbjDmPMWdc_LU5q2ta06-lp8fMzWJmMd_HezMiP6L3Xe3QtY0SXTsMDkk6jTZjQxqX74Gc_QQp7lDy6WZLKWURyTBDQJ9BGpmAU2ljr78BBDi9gkimLDKScbcFadBuki7OVLv1-Fo0-HLGsytC1tObOSacMxOfFk1HaCC-O91nx9fzD7faivLr5eLndXJWKNU0qh64jtR4bhtthqKmSmEvgLWjJepLPwBnGquZ0lLjjjEHLh4GRQbZadwwIPSteH-rOwX9fICYxmajyb6UDv0RBKCd12_eYZbQ-oCr4GAOMYg5mkmEvCBarK2InVlfE6orATGRXsujVsf4yTKD_Sv7YkIG3BwBylz8MBBFz_07lmQZQSWhv_l__3T9yZY0zStpvsIe480tweX6CiFgLLL6se7GuBaEYk67h9BcLiLYX</recordid><startdate>20130701</startdate><enddate>20130701</enddate><creator>Hoffmeister, Paul A</creator><creator>Storer, Barry E</creator><creator>Macris, Paula Charuhas</creator><creator>Carpenter, Paul A</creator><creator>Baker, K. Scott</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130701</creationdate><title>Relationship of Body Mass Index and Arm Anthropometry to Outcomes after Pediatric Allogeneic Hematopoietic Cell Transplantation for Hematologic Malignancies</title><author>Hoffmeister, Paul A ; Storer, Barry E ; Macris, Paula Charuhas ; Carpenter, Paul A ; Baker, K. Scott</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-b8812df5406bb23ca07ae76eda491a49b7400c273fa08744e67bb41ba6dd84e13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Anthropometry</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Arm - anatomy & histology</topic><topic>Arm anthropometry</topic><topic>Body Mass Index</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Chronic Disease</topic><topic>Female</topic><topic>Graft vs Host Disease - diagnosis</topic><topic>Graft vs Host Disease - pathology</topic><topic>Graft vs Host Disease - therapy</topic><topic>Hematologic malignancy</topic><topic>Hematologic Neoplasms - diagnosis</topic><topic>Hematologic Neoplasms - pathology</topic><topic>Hematologic Neoplasms - therapy</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Hematopoietic cell transplantation</topic><topic>Hematopoietic Stem Cell Transplantation</topic><topic>Humans</topic><topic>Male</topic><topic>Muscle, Skeletal - anatomy & histology</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Subcutaneous Fat - anatomy & histology</topic><topic>Survival Analysis</topic><topic>Transplantation Conditioning</topic><topic>Transplantation, Homologous</topic><topic>Treatment Outcome</topic><toplevel>online_resources</toplevel><creatorcontrib>Hoffmeister, Paul A</creatorcontrib><creatorcontrib>Storer, Barry E</creatorcontrib><creatorcontrib>Macris, Paula Charuhas</creatorcontrib><creatorcontrib>Carpenter, Paul A</creatorcontrib><creatorcontrib>Baker, K. Scott</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Biology of blood and marrow transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hoffmeister, Paul A</au><au>Storer, Barry E</au><au>Macris, Paula Charuhas</au><au>Carpenter, Paul A</au><au>Baker, K. Scott</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Relationship of Body Mass Index and Arm Anthropometry to Outcomes after Pediatric Allogeneic Hematopoietic Cell Transplantation for Hematologic Malignancies</atitle><jtitle>Biology of blood and marrow transplantation</jtitle><addtitle>Biol Blood Marrow Transplant</addtitle><date>2013-07-01</date><risdate>2013</risdate><volume>19</volume><issue>7</issue><spage>1081</spage><epage>1086</epage><pages>1081-1086</pages><issn>1083-8791</issn><eissn>1523-6536</eissn><abstract><![CDATA[Abstract Although nutritional status may adversely affect various health outcomes, the relationship between anthropometry and outcomes after hematopoietic cell transplantation (HCT) has not been fully studied in children. We analyzed the impact of pre-HCT body mass index (BMI), arm muscle area, and arm fat area on outcomes in 733 patients age 2-18 years who underwent allogeneic HCT for a hematologic malignancy between 1985 and 2009. We evaluated these 3 variables according to patient group based on age- and sex-adjusted percentiles for BMI, arm muscle area (<5th, 5th-24th, 25th-94th, and ≥95th), and arm fat area (<25th, 25th-94th, and ≥95th). Cox proportional hazards regression models for event-free survival (EFS), relapse, and nonrelapse mortality (NRM) at 100 days and 3 years after HCT, as well as grade II-IV acute graft-versus-host disease (GVHD) and chronic GVHD, were performed using the 3 major variables and adjusted for covariates. BMI was <5th percentile in only 3% of patients and ≥95th percentile in 15% of patients, but outcomes for both groups were similar to those for the BMI 25th-94th percentile group. The BMI 5th-24th percentile group had lower EFS ( P = .01) and higher relapse ( P = .003) at day +100 post-HCT, but these associations did not hold at 3 years post-HCT. Arm muscle area was <5th percentile in 8% of patients, and arm fat area was <25th percentile in 10%. Analysis of arm muscle area showed that the <5th percentile group had lower EFS and higher NRM and relapse rate at day +100 ( P = .002, .04, and .01, respectively) and 3 years ( P = .0004, .008, and .01, respectively) post-HCT. Arm fat area <25th percentile was associated with lower EFS at day +100 (hazard ratio, 1.5; P = .05), but not at 3 years post-HCT. Anthropometry variables were not associated with acute or chronic GVHD. In conclusion, arm muscle area <5th percentile appears to be a stronger predictor than BMI of poor outcomes after HCT in children with hematologic malignancies.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23623893</pmid><doi>10.1016/j.bbmt.2013.04.017</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Biology of blood and marrow transplantation, 2013-07, Vol.19 (7), p.1081-1086 |
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| subjects | Acute Disease Adolescent Anthropometry Antineoplastic Agents - therapeutic use Arm - anatomy & histology Arm anthropometry Body Mass Index Child Child, Preschool Children Chronic Disease Female Graft vs Host Disease - diagnosis Graft vs Host Disease - pathology Graft vs Host Disease - therapy Hematologic malignancy Hematologic Neoplasms - diagnosis Hematologic Neoplasms - pathology Hematologic Neoplasms - therapy Hematology, Oncology and Palliative Medicine Hematopoietic cell transplantation Hematopoietic Stem Cell Transplantation Humans Male Muscle, Skeletal - anatomy & histology Proportional Hazards Models Retrospective Studies Subcutaneous Fat - anatomy & histology Survival Analysis Transplantation Conditioning Transplantation, Homologous Treatment Outcome |
| title | Relationship of Body Mass Index and Arm Anthropometry to Outcomes after Pediatric Allogeneic Hematopoietic Cell Transplantation for Hematologic Malignancies |
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