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![Access through your institution Buy or subscribe Improving outcomes in allogeneic hematopoietic cell transplantation (HCT) depends on reducing transplant related mortality (TRM). Weight could potentiate TRM thus its role in posttransplant outcomes has been queried. Most studies conclude pretransplant obesity predicts adverse outcomes [1,2,3]. Literature regarding the prognostic value of being underweight is less robust. Some studies report that being underweight leads to increased rates of graft versus host disease (GVHD) and lower relapse free survival [4, 5]. However, most of these studies are either small [4] or non-United States (US) based [5]. The largest study to date was conducted in the Japanese population [5]. Evidence suggests that Asian populations have different associations between BMI, percentage of body fat, and health risks than do European populations making it hard to extrapolate these outcomes to the majority of HCT patients [6]. The hematopoietic cell transplantation specific comorbidity index classifies obesity as a negative risk factor but does not list low BMI [7]. The aim of this study was to evaluate the influence of pretransplant BMI on outcomes of HCT in a US population. This study was approved by the internal review board at Mayo Clinic Arizona. A total of 635 patients underwent their first HCT between January 2008 and May 2016. A total of 384 patients were included after removing those with missing data and stem cell sources other than peripheral blood. Data were obtained retrospectively from the HCT database and patient charts. Pretransplant BMI was calculated using: weight (kg)/height2 (m2). Pretransplant weight was recorded from the HCT admission history and physical. Patients were sorted by diagnosis and classified into four risk categories (MPD patients had no risk classification) [8]. All HCTs were matched unrelated donor or matched related donor. All patients were classified by their conditioning regimen intensity: high dose, reduced-intensity, and nonmyeloablative. Targeted pharmacokinetic dosing was used according to institutional protocol. Chemotherapy was based on BSA using the ideal body weight or actual body weight, whichever was lower. In patients who were greater than 125% of their ideal body weight, a corrected body weight was used, using the formula CIBW = IBW + 0.25 × (actual weight − IBW). This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 12 print issues and online access $259.00 per year only $21.58 per issue Learn more Buy this article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices may be subject to local taxes which are calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES * Fuji S, Kim S, Yoshimura K, Akiyama H, Okamoto S, Sao H, et al. Possible association between obesity and post-transplantation complications including infectious diseases and acute graft-versus-host disease. Biol Blood Marrow Transpl. 2009;15:73–82. Article Google Scholar * Nakao M, Chihara D, Niimi A, Ueda R, Tanaka H, Morishima Y, et al. Impact of being overweight on outcomes of hematopoietic SCT: a meta-analysis. Bone Marrow Transplant. 2013;49:66–72. Article Google Scholar * Weiss BM, Vogl DT, Berger NA, Stadtmauer EA, Lazarus HM. Trimming the fat: obesity and hematopoietic cell transplantation. Bone Marrow Transplant. 2012;48:1152–60. Article Google Scholar * Radujkovic A, Becker N, Benner A, Penack O, Platzbecker U, Stolzel F, et al. Pre-transplant weight loss predicts inferior outcome after allogeneic stem cell transplantation in patients with myelodysplastic syndrome. Oncotarget. 2015;6:35095–106. Article Google Scholar * Fuji S, Takano K, Mori T, Eto T, Taniguchi S, Ohashi K, et al. Impact of pre-transplant body mass index on the clinical outcomes after allogeneic hematopoietic SCT. Bone Marrow Transplant. 2014;49:1505–12. Article CAS Google Scholar * WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–63. Article Google Scholar * Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG, et al. Hematopoietic cell transplantation (HCT)- specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood. 2005;106:2912–9. Article CAS Google Scholar * Armand P, Kim HT, Logan BR, Wang Z, Alyea EP, Kalaycio ME, et al. Validation and refinement of the Disease Risk Index for allogeneic stem cell transplantation. Blood. 2014;123:3664–71. Article CAS Google Scholar Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Mayo Clinic Arizona, Department of Hematology and Medical Oncology, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA Justin Tai, Matthew Buras, Jose Leis, Pierre Noel, Jeanne Palmer, James Slack & Lisa Sproat Authors * Justin Tai View author publications You can also search for this author inPubMed Google Scholar * Matthew Buras View author publications You can also search for this author inPubMed Google Scholar * Jose Leis View author publications You can also search for this author inPubMed Google Scholar * Pierre Noel View author publications You can also search for this author inPubMed Google Scholar * Jeanne Palmer View author publications You can also search for this author inPubMed Google Scholar * James Slack View author publications You can also search for this author inPubMed Google Scholar * Lisa Sproat View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Lisa Sproat. ETHICS DECLARATIONS CONFLICT OF INTEREST The authors declare that they have no conflict of interest. ADDITIONAL INFORMATION PUBLISHER’S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Tai, J., Buras, M., Leis, J. _et al._ Pretransplant body mass index on outcomes of allogeneic hematopoietic stem cell transplantation. _Bone Marrow Transplant_ 55, 1175–1177 (2020). https://doi.org/10.1038/s41409-019-0648-4 Download citation * Received: 24 September 2018 * Revised: 19 June 2019 * Accepted: 04 July 2019 * Published: 28 August 2019 * Issue Date: June 2020 * DOI: https://doi.org/10.1038/s41409-019-0648-4 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative](data:image/svg+xml;base64,<svg height="81" width="57" xmlns="http://www.w3.org/2000/svg"><g fill="none" fill-rule="evenodd"><path d="m17.35 35.45 21.3-14.2v-17.03h-21.3" fill="#989898"/><path d="m38.65 35.45-21.3-14.2v-17.03h21.3" fill="#747474"/><path d="m28 .5c-12.98 0-23.5 10.52-23.5 23.5s10.52 23.5 23.5 23.5 23.5-10.52 23.5-23.5c0-6.23-2.48-12.21-6.88-16.62-4.41-4.4-10.39-6.88-16.62-6.88zm0 41.25c-9.8 0-17.75-7.95-17.75-17.75s7.95-17.75 17.75-17.75 17.75 7.95 17.75 17.75c0 4.71-1.87 9.22-5.2 12.55s-7.84 5.2-12.55 5.2z" fill="#535353"/><path d="m41 36c-5.81 6.23-15.23 7.45-22.43 2.9-7.21-4.55-10.16-13.57-7.03-21.5l-4.92-3.11c-4.95 10.7-1.19 23.42 8.78 29.71 9.97 6.3 23.07 4.22 30.6-4.86z" fill="#9c9c9c"/><path d="m.2 58.45c0-.75.11-1.42.33-2.01s.52-1.09.91-1.5c.38-.41.83-.73 1.34-.94.51-.22 1.06-.32 1.65-.32.56 0 1.06.11 1.51.35.44.23.81.5 1.1.81l-.91 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Access through your institution Buy or subscribe Improving outcomes in allogeneic hematopoietic cell transplantation (HCT) depends on reducing transplant related mortality (TRM). Weight
could potentiate TRM thus its role in posttransplant outcomes has been queried. Most studies conclude pretransplant obesity predicts adverse outcomes [1,2,3]. Literature regarding the
prognostic value of being underweight is less robust. Some studies report that being underweight leads to increased rates of graft versus host disease (GVHD) and lower relapse free survival
[4, 5]. However, most of these studies are either small [4] or non-United States (US) based [5]. The largest study to date was conducted in the Japanese population [5]. Evidence suggests
that Asian populations have different associations between BMI, percentage of body fat, and health risks than do European populations making it hard to extrapolate these outcomes to the
majority of HCT patients [6]. The hematopoietic cell transplantation specific comorbidity index classifies obesity as a negative risk factor but does not list low BMI [7]. The aim of this
study was to evaluate the influence of pretransplant BMI on outcomes of HCT in a US population. This study was approved by the internal review board at Mayo Clinic Arizona. A total of 635
patients underwent their first HCT between January 2008 and May 2016. A total of 384 patients were included after removing those with missing data and stem cell sources other than peripheral
blood. Data were obtained retrospectively from the HCT database and patient charts. Pretransplant BMI was calculated using: weight (kg)/height2 (m2). Pretransplant weight was recorded from
the HCT admission history and physical. Patients were sorted by diagnosis and classified into four risk categories (MPD patients had no risk classification) [8]. All HCTs were matched
unrelated donor or matched related donor. All patients were classified by their conditioning regimen intensity: high dose, reduced-intensity, and nonmyeloablative. Targeted pharmacokinetic
dosing was used according to institutional protocol. Chemotherapy was based on BSA using the ideal body weight or actual body weight, whichever was lower. In patients who were greater than
125% of their ideal body weight, a corrected body weight was used, using the formula CIBW = IBW + 0.25 × (actual weight − IBW). This is a preview of subscription content, access via your
institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 12 print issues and online access $259.00 per year only $21.58 per issue Learn more Buy this
article * Purchase on SpringerLink * Instant access to full article PDF Buy now Prices may be subject to local taxes which are calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in
* Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES * Fuji S, Kim S, Yoshimura K, Akiyama H, Okamoto S, Sao H, et al. Possible association between
obesity and post-transplantation complications including infectious diseases and acute graft-versus-host disease. Biol Blood Marrow Transpl. 2009;15:73–82. Article Google Scholar * Nakao
M, Chihara D, Niimi A, Ueda R, Tanaka H, Morishima Y, et al. Impact of being overweight on outcomes of hematopoietic SCT: a meta-analysis. Bone Marrow Transplant. 2013;49:66–72. Article
Google Scholar * Weiss BM, Vogl DT, Berger NA, Stadtmauer EA, Lazarus HM. Trimming the fat: obesity and hematopoietic cell transplantation. Bone Marrow Transplant. 2012;48:1152–60. Article
Google Scholar * Radujkovic A, Becker N, Benner A, Penack O, Platzbecker U, Stolzel F, et al. Pre-transplant weight loss predicts inferior outcome after allogeneic stem cell
transplantation in patients with myelodysplastic syndrome. Oncotarget. 2015;6:35095–106. Article Google Scholar * Fuji S, Takano K, Mori T, Eto T, Taniguchi S, Ohashi K, et al. Impact of
pre-transplant body mass index on the clinical outcomes after allogeneic hematopoietic SCT. Bone Marrow Transplant. 2014;49:1505–12. Article CAS Google Scholar * WHO Expert Consultation.
Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet. 2004;363:157–63. Article Google Scholar * Sorror ML, Maris MB, Storb
R, Baron F, Sandmaier BM, Maloney DG, et al. Hematopoietic cell transplantation (HCT)- specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood.
2005;106:2912–9. Article CAS Google Scholar * Armand P, Kim HT, Logan BR, Wang Z, Alyea EP, Kalaycio ME, et al. Validation and refinement of the Disease Risk Index for allogeneic stem
cell transplantation. Blood. 2014;123:3664–71. Article CAS Google Scholar Download references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Mayo Clinic Arizona, Department of Hematology
and Medical Oncology, 5777 East Mayo Boulevard, Phoenix, AZ, 85054, USA Justin Tai, Matthew Buras, Jose Leis, Pierre Noel, Jeanne Palmer, James Slack & Lisa Sproat Authors * Justin Tai
View author publications You can also search for this author inPubMed Google Scholar * Matthew Buras View author publications You can also search for this author inPubMed Google Scholar *
Jose Leis View author publications You can also search for this author inPubMed Google Scholar * Pierre Noel View author publications You can also search for this author inPubMed Google
Scholar * Jeanne Palmer View author publications You can also search for this author inPubMed Google Scholar * James Slack View author publications You can also search for this author
inPubMed Google Scholar * Lisa Sproat View author publications You can also search for this author inPubMed Google Scholar CORRESPONDING AUTHOR Correspondence to Lisa Sproat. ETHICS
DECLARATIONS CONFLICT OF INTEREST The authors declare that they have no conflict of interest. ADDITIONAL INFORMATION PUBLISHER’S NOTE: Springer Nature remains neutral with regard to
jurisdictional claims in published maps and institutional affiliations. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Tai, J., Buras, M., Leis, J. _et
al._ Pretransplant body mass index on outcomes of allogeneic hematopoietic stem cell transplantation. _Bone Marrow Transplant_ 55, 1175–1177 (2020). https://doi.org/10.1038/s41409-019-0648-4
Download citation * Received: 24 September 2018 * Revised: 19 June 2019 * Accepted: 04 July 2019 * Published: 28 August 2019 * Issue Date: June 2020 * DOI:
https://doi.org/10.1038/s41409-019-0648-4 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not
currently available for this article. Copy to clipboard Provided by the Springer Nature SharedIt content-sharing initiative