Effect of body mass in children with hematologic malignancies undergoing allogeneic bone marrow transplantation
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 bo...
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| Veröffentlicht in: | Blood 2014-05, Vol.123 (22), p.3504-3511 |
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| creator | Aplenc, Richard Zhang, Mei-Jie Sung, Lillian Zhu, Xiaochun Ho, Vincent T. Cooke, Kenneth Dvorak, Christopher Hale, Gregory Isola, Luis M. Lazarus, Hillard M. McCarthy, Philip L. Olsson, Richard Pulsipher, Michael Pasquini, Marcelo C. Bunin, Nancy |
| description | 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.
•There is no difference in survival after BMT among children of different BMI. |
| doi_str_mv | 10.1182/blood-2013-03-490334 |
| format | Article |
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•There is no difference in survival after BMT among children of different BMI.</description><identifier>ISSN: 0006-4971</identifier><identifier>ISSN: 1528-0020</identifier><identifier>EISSN: 1528-0020</identifier><identifier>DOI: 10.1182/blood-2013-03-490334</identifier><identifier>PMID: 24711663</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Antineoplastic Combined Chemotherapy Protocols - administration & dosage ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Body Mass Index ; Body Weight ; Bone Marrow Transplantation ; Canada ; Cause of Death ; Child ; Child, Preschool ; Female ; Hematologic Neoplasms - mortality ; Hematologic Neoplasms - therapy ; Humans ; Male ; Pediatric Obesity ; Recurrence ; Transplantation ; Transplantation, Homologous ; Treatment Outcome ; United States</subject><ispartof>Blood, 2014-05, Vol.123 (22), p.3504-3511</ispartof><rights>2014 American Society of Hematology</rights><rights>2014 by The American Society of Hematology.</rights><rights>2014 by The American Society of Hematology 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c538t-1348eaa4170fd09731626dc3c5631a02af6f693d9acbec9b651abdb4865ee2803</citedby><cites>FETCH-LOGICAL-c538t-1348eaa4170fd09731626dc3c5631a02af6f693d9acbec9b651abdb4865ee2803</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,550,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24711663$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-246896$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:129831070$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Aplenc, Richard</creatorcontrib><creatorcontrib>Zhang, Mei-Jie</creatorcontrib><creatorcontrib>Sung, Lillian</creatorcontrib><creatorcontrib>Zhu, Xiaochun</creatorcontrib><creatorcontrib>Ho, Vincent T.</creatorcontrib><creatorcontrib>Cooke, Kenneth</creatorcontrib><creatorcontrib>Dvorak, Christopher</creatorcontrib><creatorcontrib>Hale, Gregory</creatorcontrib><creatorcontrib>Isola, Luis M.</creatorcontrib><creatorcontrib>Lazarus, Hillard M.</creatorcontrib><creatorcontrib>McCarthy, Philip L.</creatorcontrib><creatorcontrib>Olsson, Richard</creatorcontrib><creatorcontrib>Pulsipher, Michael</creatorcontrib><creatorcontrib>Pasquini, Marcelo C.</creatorcontrib><creatorcontrib>Bunin, Nancy</creatorcontrib><creatorcontrib>on behalf of the Regimen-Related Toxicity Working Committee, Center for International Blood and Marrow Transplant Research</creatorcontrib><creatorcontrib>Regimen-Related Toxicity Working Committee, Center for International Blood and Marrow Transplant Research</creatorcontrib><title>Effect of body mass in children with hematologic malignancies undergoing allogeneic bone marrow transplantation</title><title>Blood</title><addtitle>Blood</addtitle><description>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.
•There is no difference in survival after BMT among children of different BMI.</description><subject>Adolescent</subject><subject>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Body Mass Index</subject><subject>Body Weight</subject><subject>Bone Marrow Transplantation</subject><subject>Canada</subject><subject>Cause of Death</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Hematologic Neoplasms - mortality</subject><subject>Hematologic Neoplasms - therapy</subject><subject>Humans</subject><subject>Male</subject><subject>Pediatric Obesity</subject><subject>Recurrence</subject><subject>Transplantation</subject><subject>Transplantation, Homologous</subject><subject>Treatment Outcome</subject><subject>United States</subject><issn>0006-4971</issn><issn>1528-0020</issn><issn>1528-0020</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>D8T</sourceid><recordid>eNp9kktv1DAQxy0EokvhGyCUIwcC40e8yQWpastDqsQFuFqOPckasvZiJ1312zNll0IPcPLI85v3n7HnHF5z3oo3_ZSSrwVwWYOsVQdSqgdsxRvR1gACHrIVAGjyrPkJe1LKNwCupGgesxOh1pxrLVcsXQ4DurlKQ9Unf1NtbSlViJXbhMlnjNU-zJtqg1s7pymNwRExhTHa6AKWaoke85hCHCs7kR8jEtKniMTlnPbVnG0su8nG2c4hxafs0WCngs-O7yn78u7y8_mH-urT-4_nZ1e1a2Q711yqFq1VfA2Dh24tuRbaO-kaLbkFYQc96E76zroeXdfrhtve96rVDaJoQZ6y-pC37HG39GaXAzV0Y5IN5vj1nSw0jRAKFPGv_slfhK9nJuXRLIsRSredJvztASd2i95hpDmne1H3PTFszJiuDdWizbeU4OUxQU4_Fiyz2YbicKJFYVqK4Y2ErlFCc0LVAXU5lZJxuCvDwdxKwfySgrmVggFpDlKgsBd_t3gX9Pv2f2ZAusN1wGwK3TQ69CGTJIxP4f8VfgIaAsmv</recordid><startdate>20140529</startdate><enddate>20140529</enddate><creator>Aplenc, Richard</creator><creator>Zhang, Mei-Jie</creator><creator>Sung, Lillian</creator><creator>Zhu, Xiaochun</creator><creator>Ho, Vincent T.</creator><creator>Cooke, Kenneth</creator><creator>Dvorak, Christopher</creator><creator>Hale, Gregory</creator><creator>Isola, Luis M.</creator><creator>Lazarus, Hillard M.</creator><creator>McCarthy, Philip L.</creator><creator>Olsson, Richard</creator><creator>Pulsipher, Michael</creator><creator>Pasquini, Marcelo C.</creator><creator>Bunin, Nancy</creator><general>Elsevier Inc</general><general>American Society of Hematology</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><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>DF2</scope><scope>D8T</scope><scope>ZZAVC</scope></search><sort><creationdate>20140529</creationdate><title>Effect of body mass in children with hematologic malignancies undergoing allogeneic bone marrow transplantation</title><author>Aplenc, Richard ; Zhang, Mei-Jie ; Sung, Lillian ; Zhu, Xiaochun ; Ho, Vincent T. ; Cooke, Kenneth ; Dvorak, Christopher ; Hale, Gregory ; Isola, Luis M. ; Lazarus, Hillard M. ; McCarthy, Philip L. ; Olsson, Richard ; Pulsipher, Michael ; Pasquini, Marcelo C. ; Bunin, Nancy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c538t-1348eaa4170fd09731626dc3c5631a02af6f693d9acbec9b651abdb4865ee2803</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Antineoplastic Combined Chemotherapy Protocols - administration & dosage</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Body Mass Index</topic><topic>Body Weight</topic><topic>Bone Marrow Transplantation</topic><topic>Canada</topic><topic>Cause of Death</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Hematologic Neoplasms - mortality</topic><topic>Hematologic Neoplasms - therapy</topic><topic>Humans</topic><topic>Male</topic><topic>Pediatric Obesity</topic><topic>Recurrence</topic><topic>Transplantation</topic><topic>Transplantation, Homologous</topic><topic>Treatment Outcome</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aplenc, Richard</creatorcontrib><creatorcontrib>Zhang, Mei-Jie</creatorcontrib><creatorcontrib>Sung, Lillian</creatorcontrib><creatorcontrib>Zhu, Xiaochun</creatorcontrib><creatorcontrib>Ho, Vincent T.</creatorcontrib><creatorcontrib>Cooke, Kenneth</creatorcontrib><creatorcontrib>Dvorak, Christopher</creatorcontrib><creatorcontrib>Hale, Gregory</creatorcontrib><creatorcontrib>Isola, Luis M.</creatorcontrib><creatorcontrib>Lazarus, Hillard M.</creatorcontrib><creatorcontrib>McCarthy, Philip L.</creatorcontrib><creatorcontrib>Olsson, Richard</creatorcontrib><creatorcontrib>Pulsipher, Michael</creatorcontrib><creatorcontrib>Pasquini, Marcelo C.</creatorcontrib><creatorcontrib>Bunin, Nancy</creatorcontrib><creatorcontrib>on behalf of the Regimen-Related Toxicity Working Committee, Center for International Blood and Marrow Transplant Research</creatorcontrib><creatorcontrib>Regimen-Related Toxicity Working Committee, Center for International Blood and Marrow Transplant Research</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><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Uppsala universitet</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>Blood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aplenc, Richard</au><au>Zhang, Mei-Jie</au><au>Sung, Lillian</au><au>Zhu, Xiaochun</au><au>Ho, Vincent T.</au><au>Cooke, Kenneth</au><au>Dvorak, Christopher</au><au>Hale, Gregory</au><au>Isola, Luis M.</au><au>Lazarus, Hillard M.</au><au>McCarthy, Philip L.</au><au>Olsson, Richard</au><au>Pulsipher, Michael</au><au>Pasquini, Marcelo C.</au><au>Bunin, Nancy</au><aucorp>on behalf of the Regimen-Related Toxicity Working Committee, Center for International Blood and Marrow Transplant Research</aucorp><aucorp>Regimen-Related Toxicity Working Committee, Center for International Blood and Marrow Transplant Research</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of body mass in children with hematologic malignancies undergoing allogeneic bone marrow transplantation</atitle><jtitle>Blood</jtitle><addtitle>Blood</addtitle><date>2014-05-29</date><risdate>2014</risdate><volume>123</volume><issue>22</issue><spage>3504</spage><epage>3511</epage><pages>3504-3511</pages><issn>0006-4971</issn><issn>1528-0020</issn><eissn>1528-0020</eissn><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.
•There is no difference in survival after BMT among children of different BMI.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24711663</pmid><doi>10.1182/blood-2013-03-490334</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - therapeutic use Body Mass Index Body Weight Bone Marrow Transplantation Canada Cause of Death Child Child, Preschool Female Hematologic Neoplasms - mortality Hematologic Neoplasms - therapy Humans Male Pediatric Obesity Recurrence Transplantation Transplantation, Homologous Treatment Outcome United States |
| title | Effect of body mass in children with hematologic malignancies undergoing allogeneic bone marrow transplantation |
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