Impact of Obesity on Clinical Outcomes of Elderly Patients Undergoing Allogeneic Hematopoietic Cell Transplantation for Myeloid Malignancies
| Autor: | Wael Saber, Timothy S. Fenske, Aniko Szabo, Ensi Voshtina, William R. Drobyski, Mehdi Hamadani, Parameswaran Hari, Nirav N. Shah, Saurabh Chhabra, Anita D'Souza |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Oncology medicine.medical_specialty Myeloid Allogeneic transplantation Physical function Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Older patients Internal medicine medicine Humans Obesity Aged Retrospective Studies Transplantation Hematopoietic cell business.industry Hematopoietic Stem Cell Transplantation Hematology Middle Aged Allografts medicine.disease Survival Rate Leukemia Myeloid Acute surgical procedures operative medicine.anatomical_structure Primary Myelofibrosis Hematologic Neoplasms Myelodysplastic Syndromes 030220 oncology & carcinogenesis Female business Body mass index 030215 immunology |
| Zdroj: | Biology of Blood and Marrow Transplantation. 25:e33-e38 |
| ISSN: | 1083-8791 |
| DOI: | 10.1016/j.bbmt.2018.08.031 |
| Popis: | Allogeneic hematopoietic cell transplantation (allo-HCT) is a high-risk treatment option for patients with hematologic malignancies. Advanced age and obesity can impact outcomes after allo-HCT. Previous registry studies of all age groups found that obesity does not affect outcomes. However, obesity can accelerate age-related decline in physical function and exacerbate comorbid conditions in older patients. Studies evaluating the effect of obesity on elderly patients undergoing allo-HCT are lacking. We performed a retrospective analysis of 86 nonobese (body mass index [BMI]30) and obese (BMI ≥30) patients age ≥60 years who underwent allo-HCT for myeloid malignancies between January 2010 and June 2015. We found no significant between-group differences in mean age, sex, comorbid conditions, cytogenetic risk, disease indication for transplantation, or donor type. The median overall survival (OS) was 36 months for the BMI30 group and 24 months for the BMI ≥30 group (P = .55). The median progression-free survival (PFS) was 10.1 months in the BMI30 group and 13.6 months in the BMI ≥30 group (P = .93). There were no significant between-group differences in acute graft-versus-host disease (GVHD) and cumulative incidence of chronic GVHD at 1 year post-transplantation. Among patients admitted for transplantation, the mean length of stay was 25 days in the BMI30 group and 26 days in the BMI ≥30 group (P = .64). The rate of readmission within 30 days of discharge was significantly higher in the BMI ≥30 group (34% versus 16%; P = .045). Our data reveal that in these elderly patients with myeloid malignancies undergoing allo-HCT, clinical outcomes, including OS, PFS, and GVHD, were not affected by obesity. Thus, in elderly patients, obesity should not preclude consideration for curative allo-HCT and does not portend worse outcomes after allo-HCT. |
| Databáze: | OpenAIRE |
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