Obesity does not preclude safe and effective myeloablative hematopoietic cell transplantation (HCT) for acute myelogenous leukemia (AML) in adults.

Obesity does not preclude safe and effective myeloablative hematopoietic cell transplantation (HCT) for acute myelogenous leukemia (AML) in adults.
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DOI:
10.1016/j.bbmt.2010.04.009
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发表时间:
2010-10
影响因子:
4.3
通讯作者:
Rizzo, J. Douglas
Rizzo, J. Douglas
中科院分区:
医学2区
文献类型:
--
作者:
Navarro, Willis H.;Agovi, Manza-A;Logan, Brent R.;Ballen, Karen;Bolwel, Brian J.;Frangoul, Haydar;Gupta, Vikas;Hahn, Theresa;Ho, Vincent T.;Juckett, Mark;Lazarus, Hillard M.;Litzow, Mark R.;Liesveld, Jane L.;Moreb, Jan S.;Marks, David I.;McCarthy, Philip L.;Pasquini, Marcelo C.;Rizzo, J. Douglas

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过度肥胖的发病率在全球范围内不断增加,并与许多不良健康后果相关。我们通过体重指数(BMI)比较了接受自体骨髓移植的成人急性髓性白血病(AML)患者的结局。(自动,n=373),相关供体(RD,n=2041)或无关供体(URD,n=1801)向国际血液和骨髓移植研究中心(CIBMTR)报告的使用骨髓或外周血干细胞的异基因清髓性造血细胞移植(HCT)从1995年到2004年按BMI(kg/m2)定义了四个体重组:体重不足< 18;正常18 - 25;超重>25 - 30;肥胖> 30。参考正常体重组的多变量分析显示,RD组体重不足患者的死亡风险增加(RR,1.92; 95% CI,1.28-2.89; P = 0.002),但URD组未增加。在其他HCT组中,其他体重组之间的结局无其他差异。超重和肥胖患者的复发率略有下降,但这并没有转化为生存益处。患者数量较少限制了更好地描述体重不足RD患者(而非体重不足URD同种异体HCT患者)中观察到的不良结局的能力。肥胖本身不应被视为HCT的障碍。
The incidence of excessive adiposity is increasing worldwide and is associated with numerous adverse health outcomes. We compared outcomes by body mass index (BMI) for adult patients with acute myeloid leukemia (AML) who underwent autologous (auto, n=373), related donor (RD, n=2041), or unrelated donor (URD, n=1801) allogeneic myeloablative hematopoietic cell transplantation (HCT) using marrow or peripheral blood stem cells reported to the Center for International Blood and Marrow Transplant Research (CIBMTR) from 1995-2004. Four weight groups by BMI (kg/m2) were defined: underweight < 18; normal 18 – 25; overweight >25 – 30; and obese > 30. Multivariable analysis referenced to the normal weight group showed an increased risk of death for underweight patients in the RD group (RR, 1.92; 95% CI, 1.28-2.89; P = 0.002) but not in the URD group. There were no other differences in outcomes among the other weight groups within the other HCT groups. Overweight and obese patients enjoyed a modest decrease in relapse incidence, though this did not translate into a survival benefit. Small numbers of patients limit the ability to better characterize the adverse outcomes seen in the underweight RD but not the underweight URD allogeneic HCT patients. Obesity alone should not be considered a barrier to HCT.
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