Effect of body mass index on mortality of patients with lymphoma undergoing autologous hematopoietic cell transplantation
Effect of body mass index on mortality of patients with lymphoma undergoing autologous hematopoietic cell transplantation
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DOI：
10.1016/j.bbmt.2005.12.033
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发表时间：
2006-05-01
影响因子：
4.3
通讯作者：
Rizzo, JD
中科院分区：
文献类型：
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作者：
Navarro, WH;Loberiza, FR;Rizzo, JD
自体造血细胞移植（auto-HT）的高剂量治疗经常用于改善淋巴瘤的结局。然而，小型研究表明肥胖患者的生存劣势。采用回顾性队列分析，我们研究了1990年至2000年期间根据体重指数（BMI）接受霍奇金或非霍奇金淋巴瘤自体HCT的4681例患者的结局。采用考克斯比例风险回归对按BMI分类的四组进行比较，以调整其他预后因素。在HCT时，共有1909名患者被归类为正常体重（BMI 18-25 kg/m2），121名为体重不足（BMI > 18 kg/m2），1725名为超重（BMI > 25-30 kg/m2），926名为肥胖（BMI > 30 kg/m2）。评估的结果包括总生存率、复发率、移植相关死亡率。与正常BMI组相比，TRM体重不足组有更高的TRIM风险（相对风险[RR]，2.46; 95%置信区间[CI]，1.59-3.82; P < 0.0001）。复发率无差异。体重不足组的总死亡率较高（RR，1.48; 95%CI，1.17-1.88; P=.001），超重组（RR，0.87; 95%CI，0.79-0.96; P=.004）和肥胖组（RR，0.76; 95%CI，0.67-0.86; P =.001）的总死亡率较低。
High-dose therapy with autologous hematopoietic cell transplantation (auto-HT) is frequently used to improve outcomes in lymphoma. However, small studies suggest a survival disadvantage among obese patients. Using a retrospective cohort analysis, we studied the outcomes of 4681 patients undergoing auto-HCT for Hodgkin or non-Hodgkin lymphoma between 1990 and 2000 according to body mass index (BMI). Four groups categorized by BMI were compared by using Cox proportional hazards regression to adjust for other prognostic factors. A total of 1909 patients were categorized as normal weight (BMI 18-25 kg/m(2)), 121 as underweight (BMI > 18 kg/m(2)), 1725 as overweight (BMI > 25-30 kg/m(2)), and 926 as obese (BMI > 30 kg/m(2)) at the time of HCT. Outcomes evaluated included overall survival, relapse, transplantation-related mortality TRM underweight group had a higher risk of TRIM (relative risk [RR], 2.46; 95% confidence interval [CI], 1.59-3.82; P < 0.0001) compared with the normal-BMI group. No differences in relapse were noted. Overall mortality was higher in the under-weight group (RR, 1.48; 95% CI, 1.17-1.88; P=.001) and lower in the overweight (RR, 0.87; 95% CI, 0.79-0.96; P=.004) and obese (RR, 0.76; 95% CI, 0.67-0.86; P