TITLE

Allogeneic transplant outcomes are not affected by body mass index (BMI) in patients with haematological malignancies

AUTHOR(S)
Nikolousis, Emmanouil; Nagra, Sandeep; Paneesha, Shankara; Delgado, Julio; Holder, Kathy; Bratby, Lynn; Chaganti, Sridhar; Lovell, Richard; Milligan, Donald
PUB. DATE
November 2010
SOURCE
Annals of Hematology;Nov2010, Vol. 89 Issue 11, p1141
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Bone marrow transplantation is frequently used as a consolidation therapy in patients with haematological malignancies to improve the outcome of these patients. Obese individuals have larger absolute lean body and fat masses than non-obese individuals of the same age, gender and height, which might lead to altered pharmacokinetics of chemotherapeutic agents. Data on the impact of body mass on transplant outcome is conflicting. This study included 331 patients (M, 230; F, 101) with 336 allogeneic transplant episodes from two large teaching hospitals in the West Midlands region in United Kingdom. A total of 105 patients had acute myeloid leukaemia, 83 had non-Hodgkin's lymphoma, three had myeloma, 21 had Hodgkin's lymphoma, 34 had acute lymphoblastic leukaemia, 19 had chronic myeloid leukaemia, 22 had chronic lymphocytic leukaemia, 24 had myelodysplasia, seven had T cell non-Hodgkin's lymphoma, six had aplastic leukaemia and seven had myelofibrosis. At transplantation, 40% ( N = 133) of the patients had normal and 60% ( N = 198) had high body mass index (BMI) with 14% of the patients being obese (BMI >30). After a median follow-up of 24 months (range, 2-79), the mean overall survival (OS) in patients undergoing allograft with normal BMI was 31 months as compared to 39 with high BMI ( p:0.06). The mean progression free survival (PFS) in patients undergoing allograft with normal BMI was 33 months as compared to 38 with high BMI ( p = 0.13). Of the patients in the high and obese BMI group, 16% developed acute GvHD with 8% grade III-IV and 28% in the normal BMI group with 14% grade III-IV acute GvHD ( p = 0.11). Of the patients in the high BMI group, 17% developed chronic GvHD and 30% of the patients in the normal BMI group ( p = 0.09). However, higher infection rates and more days of inpatient stay in the first year post-transplant were observed in the high BMI and obese patients, but there was no difference in ITU admissions. This study shows that high BMI and obesity does not adversely impact on either OS or PFS in patients undergoing allogeneic transplantation for haematological malignancies, but it does have a significant impact on infection rates and hospitalisation of high BMI and obese patients. We recommend that patients with high BMI should not be excluded from allogeneic transplantation; however, good supportive care and careful patient selection on the basis of comorbidity index should be undertaken in order to avoid the risks from the increased rates of infection.
ACCESSION #
53704492

 

Related Articles

  • Skin Calcinosis Following Allogenic Bone Marrow Transplantation in an Acute Lymphoblastic Leukaemia Patient. Guberman, D.; Gilead, L. T.; Nagler, A. // Acta Dermato-Venereologica;6/23/99, Vol. 79 Issue 4, p324 

    Examines the skin calcinosis following bone marrow transplantation (BMT) in an acute lymphoblastic leukaemia patients. Characteristics of skin calcinosis; Signs and symptoms of the disease; Correlation between BMT and calcinosis.

  • New England Journal of Medicine: Chemotherapy proves life-saving for some leukemia patients who fail induction therapy.  // Biomedical Market Newsletter;4/14/2012, Vol. 21, p1 

    The article offers information on a study which revealed that the patients with lymphoblastic leukemia who failed induction therapy are not recommended for bone marrow transplantation.

  • Addition of high-dose Ara-C to the BMT conditioning regimen reduces leukemia relapse without an increase in toxicity. Mineishi, S; Longo, W L; Atkinson, M E; Smith, E P; Hamielec, M; Wiersma, S R; Kinsella, T J; Schuening, F G // Bone Marrow Transplantation;6/15/99, Vol. 23 Issue 12, p1217 

    The optimal conditioning regimen for allogeneic BMT for hematological malignancies is still to be determined. We used a conditioning regimen including high-dose Ara-C (HDAC)/CY/TBI for patients at high risk for leukemic relapse (regimen A, Ara-C 3 g/m2 every 12 h for six doses followed by CY 45...

  • Matchmaker. Dutt, Ela // Desi Talk;12/20/2013, Vol. 17 Issue 51, p6 

    The article offers information on the Chronic Lymphocytic Leukemia (CLL) by referring to the case of Ekata Doshi, a 38 year old resident of New York who is suffering from CLL. Topics include treatment of CLL through a bone marrow transplant and chemotherapy, and difficulties in finding donors...

  • Correspondence. Arya, S.C. // Bone Marrow Transplantation;6/1/2002, Vol. 29 Issue 11, p941 

    Comments on an article which described the declining protective immunity against poliomyelitis in several patients with malignant lymphoma after allogeneic bone marrow transplantation. Discussion on the decline in vaccine-induced protective immunity; Recommendations.

  • AUTHORS. Tuccaro Jr., Dave // SAY Magazine;Winter2014, Vol. 13 Issue 1, p22 

    In this article, the author presents his experiences on being diagnosed and operated for Acute Lymphoblastic Leukemia (ALL). He mentions that he had undergone for several medical treatments which includes chemotherapy, bone-marrow transplant, and eight rounds of hip biopsies. He informs that in...

  • Is intravesical bacillus Calmette-Guerin safe and efficacious in steroid treated and immunocompromized patients. Kumar, Santosh; Kekre, Nitin S. // Indian Journal of Urology;Jul-Sep2006, Vol. 22 Issue 3, p286 

    It is generally assumed that intravesical bacillus Calmette-Guerin (BCG) should be avoided in the setting of immunosuppression. This retrospective study[1] from the Memorial Sloan-Kettering Cancer Center was undertaken to assess the safety and efficacy of intravesical BCG instillation in 24...

  • The effect of body mass index on spinal anaesthesia for total knee replacement arthrosplasty: a dose-response study. Kim, W. H.; Lee, J. H.; Ko, J. S.; Ahn, H. J.; Park, S. K.; Gwak, M. S.; Kim, G. S. // Anaesthesia & Intensive Care;May2012, Vol. 40 Issue 3, p410 

    The article presents a study which compares the duration of spinal block anesthesia in obese and non-obese patients undergoing total knee replacement arthroplasty. It examines the effect of body mass index (BMI) on spinal anesthesia using a dose-response modelling of intrathecal hyperbaric...

  • OSOBNÍ PRÍČINNÁ ORIENTACE A ZMÄšNA TÄšLESNÉ HMOTNOSTI U ÚČASTNIC KURZU SNIŽOVÁNÍ NADVÁHY. Kintrová, Lucie; Schneidrová, Dagmar // Ceskoslovenska Psychologie;Jun2009, p261 

    The goal of the study was to find out if the type of personal causality orientation (PCO) could predict the mass decrement in participants of courses in overweight reduction with application of cognitive-behavioral therapy. The monitoring proceeded 12 weeks and during this time the respondents...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics