Obesity and autologous stem cell transplantation in acute myeloid leukemia
Obesity and autologous stem cell transplantation in acute myeloid leukemia
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DOI：
10.1038/sj.bmt.1703145
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发表时间：
2001-08-01
影响因子：
4.8
通讯作者：
Mandelli, F
中科院分区：
文献类型：
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作者：
Meloni, G;Proia, A;Mandelli, F
在骨髓移植背景下，几位作者假设严重超重的患者发生移植相关毒性的风险增加，但分析了不同的肥胖定义、不同的体重分组和异质性患者样本。为了克服这些局限性，我们回顾性地考虑了一组同质的54例患者（中位年龄36.5岁），诊断为原发性急性髓性白血病（AML），在首次完全缓解（CR）时采用Bu-Cy 2预处理方案进行自体移植，根据实际体重给药。使用体重指数（BMI = kg/m2）将患者分为三组（肥胖、非肥胖、体重不足）;我们分析了每组的移植相关毒性和死亡率、总生存率和无病生存率（OS/DFS）。尽管患者数量相对较少，但在我们的研究结果中，高BMI似乎是治疗相关毒性和死亡率增加的预测因素。此外，30例（55%）患者目前仍存活于连续CR中，在中位随访76.5个月（范围14-137）后，肥胖组和非肥胖组的OS和DFS存在统计学显著差异（分别为P = 0.012和0.021）。我们的研究表明，肥胖可能是AML自体移植的一个独立危险因素，需要进一步研究。
In the bone marrow transplant setting, several authors hypothesized that severely overweight patients are at increased risk of transplant-related toxicity, but different definitions of obesity, different body weight groupings and heterogeneous samples of patients were analyzed. To overcome these limitations, we retrospectively considered a homogeneous group of 54 patients (median age 36.5 years), with a diagnosis of de novo acute myeloid leukemia (AML), autografted in first complete remission (CR) with the Bu-Cy2 conditioning regimen, dosed on actual body weight. Patients were classified into three groups (obese, non-obese, underweight) using body mass index (BMI = kg/m(2)); for each group we analyzed transplant-related toxicity and mortality, overall survival and disease-free survival (OS/DFS). In spite of the relatively small number of patients, in our results high BMI appears a predictive factor for an increase of treatment-related toxicity and mortality. Moreover, 30 (55%) patients are currently alive in continuous CR, and after a median follow-up of 76.5 months (range 14-137) statistically significant differences in OS and DFS were detected between obese and non-obese groups (P = 0.012 and 0.021, respectively). Our study sugggests that obesity may represent an independent risk factor for autograft in AML and further investigations are warranted.