Impact of obesity on clinical outcomes of elderly patients undergoing allogeneic hematopoietic cell transplant for myeloid malignancies.

08:00 EDT 19th September 2018 | BioPortfolio

Summary of "Impact of obesity on clinical outcomes of elderly patients undergoing allogeneic hematopoietic cell transplant for myeloid malignancies."

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 non-obese (BMI <30) and obese (BMI ≥30) patients age ≥60 who underwent allo-HCT for myeloid malignancies between January 2010 to June 2015. We found no significant differences in mean age, sex, comorbid conditions, cytogenetic risk, disease indication for transplant, or donor type between the two groups. Median overall survival (OS) was 36 months for BMI<30 patients and 24 months for BMI≥30 (p=0.55). Median progression free survival was 10.1 months in the BMI<30 group and 13.6 months in the ≥30 group (p=0.93). There was no significant difference in acute graft-versus-host disease (GVHD) and cumulative incidence of chronic GVHD at 1-year post-transplant. Among patients admitted for transplant, the mean length of stay was 25 days in BMI<30 and 26 days in BMI≥30 (p=0.64). There were more patients (34% vs 16%) with BMI≥30 who were re-admitted within 30 days of discharge (p=0.045). Our study revealed that in elderly patients with myeloid malignancies undergoing allo-HCT, clinical outcomes including OS, progression free survival, and GVHD were not affected by obesity. In elderly patients, obesity should not preclude consideration for curative allo-HCT and does not portend worse outcomes after allo-HCT.


Journal Details

This article was published in the following journal.

Name: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
ISSN: 1523-6536


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Medical and Biotech [MESH] Definitions

A hematopoietic growth factor which promotes proliferation and maturation of neutrophil granulocytes. Clinically it is effective in decreasing the incidence of febrile neutropenia in patients with non-myeloid malignancies receiving myelosuppressive therapy or in reducing the duration of neutropenia and neutropenia-related clinical sequelae in patients with non-myeloid malignancies undergoing myeloblastive chemotherapy followed by BMT. It has also been used in AIDS patients with CMV retinitis being treated with GANCICLOVIR. (Gelman CR, Rumack BH & Hess AJ (eds): DRUGDEX(R) System. MICROMEDEX, Inc., Englewood, Colorado (Edition expires 11/30/95))

The treatment of patients without the use of allogeneic BLOOD TRANSFUSIONS or blood products.

Agents that increase energy expenditure and weight loss by neural and chemical regulation. Beta-adrenergic agents and serotoninergic drugs have been experimentally used in patients with non-insulin dependent diabetes mellitus (NIDDM) to treat obesity.

A psychological test consisting of true/false items. It is used as a diagnostic screening or clinical assessment of adults who evidence problematic emotional and interpersonal symptoms or who are undergoing PSYCHOTHERAPY or a psychodiagnostic evaluation.

A condition of having excess fat in the abdomen. Abdominal obesity is typically defined as waist circumferences of 40 inches or more in men and 35 inches or more in women. Abdominal obesity raises the risk of developing disorders, such as diabetes, hypertension and METABOLIC SYNDROME X.

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