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Effect of body mass in children with hematologic malignancies undergoing allogeneic bone marrow transplantation.
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2014 (English)In: Blood, ISSN 0006-4971, E-ISSN 1528-0020, Vol. 123, no 22, 3504-11 p.Article in journal (Refereed) Published
Abstract [en]

The rising incidence of pediatric obesity may significantly affect bone marrow transplantation (BMT) outcomes. We analyzed outcomes in 3687 children worldwide who received cyclophosphamide-based BMT regimens for leukemias between 1990 and 2007. Recipients were classified according to age-adjusted body mass index (BMI) percentiles as underweight (UW), at risk of UW (RUW), normal, overweight (OW), or obese (OB). Median age and race were similar in all groups. Sixty-one percent of OB children were from the United States/Canada. Three-year relapse-free and overall survival ranged from 48% to 52% (P = .54) and 55% to 58% (P = .81) across BMI groups. Three-year leukemia relapses were 33%, 33%, 29%, 25%, and 21% in the UW, RUW, normal, OW, and OB groups, respectively (P < .001). Corresponding cumulative incidences for transplant-related mortality (TRM) were 18%, 19%, 21%, 22%, and 28% (P < .01). Multivariate analysis demonstrated a decreased risk of relapse compared with normal BMI (relative risk [RR] = 0.73; P < .01) and a trend toward higher TRM (RR = 1.28; P = .014). BMI in children is not significantly associated with different survival after BMT for hematologic malignancies. Obese children experience less relapse posttransplant compared with children with normal BMI; however, this benefit is offset by excess in TRM.

Place, publisher, year, edition, pages
2014. Vol. 123, no 22, 3504-11 p.
Identifiers
URN: urn:nbn:se:uu:diva-246896DOI: 10.1182/blood-2013-03-490334PubMedID: 24711663OAI: oai:DiVA.org:uu-246896DiVA: diva2:794454
Available from: 2015-03-11 Created: 2015-03-11 Last updated: 2017-12-04

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