Effect of Body Mass Index on Mortality of Patients with Lymphoma Undergoing Autologous Hematopoietic Cell Transplantation

Willis H. Navarro, Fausto R. Loberiza, Ruta Bajorunaite, Koen van Besien, Julie Marie Vose, Hillard M. Lazarus, J. Douglas Rizzo

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

High-dose therapy with autologous hematopoietic cell transplantation (auto-HCT) 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/m2), 121 as underweight (BMI <18 kg/m2), 1725 as overweight (BMI >25-30 kg/m2), and 926 as obese (BMI >30 kg/m2) at the time of HCT. Outcomes evaluated included overall survival, relapse, transplantation-related mortality (TRM), and lymphoma-free survival. TRM was similar among the normal, overweight, and obese groups; the underweight group had a higher risk of TRM (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 underweight 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 < .0001) groups compared with the normal-BMI group. In light of our inability to find differences in survival among overweight, obese, and normal-weight patients, obesity alone should not be viewed as a contraindication to proceeding with auto-HCT for lymphoma when it is otherwise indicated.

Original languageEnglish (US)
Pages (from-to)541-551
Number of pages11
JournalBiology of Blood and Marrow Transplantation
Volume12
Issue number5
DOIs
StatePublished - May 1 2006

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Cell Transplantation
Lymphoma
Body Mass Index
Mortality
Thinness
Confidence Intervals
Survival
Transplantation
Weights and Measures
Recurrence
Hodgkin Disease
Non-Hodgkin's Lymphoma
Cohort Studies
Obesity

Keywords

  • Autologous HCT
  • Body mass index
  • Lymphoma
  • Mortality

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Effect of Body Mass Index on Mortality of Patients with Lymphoma Undergoing Autologous Hematopoietic Cell Transplantation. / Navarro, Willis H.; Loberiza, Fausto R.; Bajorunaite, Ruta; van Besien, Koen; Vose, Julie Marie; Lazarus, Hillard M.; Rizzo, J. Douglas.

In: Biology of Blood and Marrow Transplantation, Vol. 12, No. 5, 01.05.2006, p. 541-551.

Research output: Contribution to journalArticle

Navarro, Willis H. ; Loberiza, Fausto R. ; Bajorunaite, Ruta ; van Besien, Koen ; Vose, Julie Marie ; Lazarus, Hillard M. ; Rizzo, J. Douglas. / Effect of Body Mass Index on Mortality of Patients with Lymphoma Undergoing Autologous Hematopoietic Cell Transplantation. In: Biology of Blood and Marrow Transplantation. 2006 ; Vol. 12, No. 5. pp. 541-551.
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