Does recipient body mass index inform donor selection for allogeneic haematopoietic cell transplantation?

Abstract

It is not known whether obesity has a differential effect on allogeneic haematopoietic cell transplantation outcomes with alternative donor types. We report the results of a retrospective registry study examining the effect of obesity [body mass index (BMI) > 30] on outcomes with alternative donors (haploidentical related donor with two or more mismatches and receiving post‐transplant cyclophosphamide [haplo] and cord blood (CBU)] versus matched unrelated donor (MUD). Adult patients receiving haematopoietic cell transplantation for haematologic malignancy (2013–2017) (N = 16 182) using MUD (n = 11 801), haplo (n = 2894) and CBU (n = 1487) were included. The primary outcome was non‐relapse mortality (NRM). The analysis demonstrated a significant, non‐linear interaction between pretransplant BMI and the three donor groups for NRM: NRM risk was significantly higher with CBU compared to haplo at BMI 25–30 [hazard ratio (HR) 1.66–1.71, p p < 0.05). The results demonstrated that NRM and survival outcomes are worse in overweight and obese transplant recipients (BMI ≥ 25) with one alternative donor type over MUD, although obesity does not appear to confer a uniform differential mortality risk with one donor type over the other. BMI may serve as a criterion for selecting a donor among the three (MUD, haplo and CBU) options, if matched sibling donor is not available.

Document Details

Document Type
Pub Defense Publication
Publication Date
Mar 14, 2022
Source ID
10.1111/bjh.18108

Entities

People

  • Akshay Sharma
  • Amer M. Beitinjaneh
  • Bipin N Savani
  • Edward A. Stadtmauer
  • Gayathri Ravi
  • Hillard M Lazarus
  • Kwang Woo Ahn
  • Leland Metheny Iii
  • Marcelo C Pasquini
  • Marcos de Lima
  • Mariam Allbee‐johnson
  • Mohamed L Sorror
  • Mouhamed Yazan Abou‐ismail
  • Najla El Jurdi
  • Neel S Bhatt
  • Peiman Hematti
  • Raphael Fraser
  • Saurabh Chhabra
  • Sherif M Badawy
  • Taiga Nishihori

Organizations

  • Case Western Reserve University
  • Fred Hutchinson Cancer Center
  • H. Lee Moffitt Cancer Center & Research Institute
  • Health Resources and Services Administration
  • Medical College of Wisconsin
  • Northwestern University
  • Office of Naval Research
  • Ohio State University
  • St. Jude Children's Research Hospital
  • University of Alabama at Birmingham
  • University of Miami
  • University of Minnesota
  • University of Pennsylvania
  • University of Utah
  • University of Washington
  • University of Wisconsin–Madison
  • Vanderbilt University

Tags

Fields of Study

  • Medicine

Readers

  • Canine Service Warrior Training Program for Wounded Warriors in the Veterinary Industry, Supported by Donors.
  • Immunology
  • Women's Health and Cancer Risk Research: African American Women and Pregnancy Outcomes.

Technology Areas

  • Biotechnology