Effect of Body Mass Index on Overall Survival of Patients with Allogeneic Hematopoietic Stem Cell Transplantation

AIM: The present study was performed to investigate the association between body mass index (BMI) before transplantation and the overall survival (OS) of patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT).

METHODS: Data from 310 adults who were diagnosed with acute leukemia and underwent allo-HSCT between March 2001 and December 2011 were analyzed. Demographic and clinical data were collected from medical records. In accordance with the suggested BMI categories for Asian population, patients with BMIs of ≥23 and ≥25 kg/m² were identified as overweight and obese, respectively. Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using Cox proportional hazards models, which were adjusted for possible confounding factors.

RESULTS: The median follow-up time among the patients was 19.7 months (interquartile range = 8.1 to 37.7). A total of 93 (34.8%) patients died within the follow-up period. After adjusted for the potential confounders, normal-weight, overweight, and obese patients showed significantly lower HRs than underweight patients, with a significant trend of OS improvement upon increasing BMI (P = 0.019). Overweight and obese patients survived longer, with a significantly decreased HR by approximately 40% (HR = 0.60;95% CI: 0.38 to 0.95) compared with underweight and normal-weight patients.

CONCLUSIONS: An increased OS was seen in allo-HSCT patients with BMI≥23 compared to those with lower BMI. Further studies are required to obtain better understanding of the effects of BMI or body composition on the survival of allo-HSCT patients.