Document Detail


The relationship of body mass index and arm anthropometry to outcomes after pediatric allogeneic hematopoietic cell transplantation for hematologic malignancies.
MedLine Citation:
PMID:  23623893     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Although nutritional status may adversely affect various health outcomes, the relationship of anthropometry to outcomes after hematopoietic cell transplantation (HCT) has not been fully studied in children. We analyzed the impact of pre-HCT body mass index (BMI), arm-muscle-area, and arm-fat-area on HCT outcomes in 733 patients aged 2-18 years who underwent allogeneic HCT for hematologic malignancies from 1985-2009. These 3 variables were analyzed according to patient groups based on age-and-gender-adjusted percentiles for BMI and arm-muscle-area (<5th, 5th-24th, 25th-94th, ≥95th) and arm-fat-area (<25th, 25th-94th, ≥95th). Cox proportional hazards regression models for event-free survival (EFS), relapse, and non-relapse mortality (NRM) at day 100 and 3 years after HCT, grade II-IV acute graft-versus-host-disease (GVHD) and chronic GVHD were performed using the 3 major variables and adjusted for covariates. BMI was <5th percentile in 3% of patients and ≥95th percentile in 15% of patients, but outcomes for both groups were similar to the BMI 25th-94th percentile group, whereas the BMI 5th-24th percentile group had lower EFS (p= .01) and higher relapse (p= .003) at day 100 after HCT, but this association was not true at 3-years. Arm-muscle-area was <5th percentile in 8% of patients and arm-fat-area was <25th percentile in 10%. When arm-muscle-area was analyzed, the <5th percentile group had lower EFS, and both NRM and relapse were higher, respectively at day 100 (p= .002, p= .04, p= .01) and 3-years (p= .0004, p= .008, p= .01). Arm-fat-area <25th percentile was associated with lower EFS at day 100 (HR 1.5, p=0.05), but not at 3 years after HCT. Anthropometry variables were not associated with acute or chronic GVHD. In conclusion, arm-muscle-area <5th percentile appears to be a stronger predictor than BMI of poor outcomes after HCT in children with hematologic malignancies.
Authors:
Paul A Hoffmeister; Barry E Storer; Paula Charuhas Macris; Paul A Carpenter; K Scott Baker
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-4-25
Journal Detail:
Title:  Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation     Volume:  -     ISSN:  1523-6536     ISO Abbreviation:  Biol. Blood Marrow Transplant.     Publication Date:  2013 Apr 
Date Detail:
Created Date:  2013-4-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9600628     Medline TA:  Biol Blood Marrow Transplant     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
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