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Enßle JC, Wolf S, Scheich S, Weber S, Kramer M, Ruhnke L, Schliemann C, Mikesch JH, Krause S, Sauer T, Hanoun M, Reinhardt HC, Kraus S, Kaufmann M, Hänel M, Fransecky L, Burchert A, Neubauer A, Crysandt M, Jost E, Niemann D, Schäfer-Eckart K, Held G, Kaiser U, Wass M, Schaich M, Müller-Tidow C, Platzbecker U, Baldus CD, Bornhäuser M, Röllig C, Serve H, Steffen B. Impact of BMI on patient outcome in acute myeloid leukaemia patients receiving intensive induction therapy: a real-world registry experience. Br J Cancer 2023; 129:1126-1133. [PMID: 37542108 PMCID: PMC10539505 DOI: 10.1038/s41416-023-02362-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 06/06/2023] [Accepted: 07/05/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Acute myeloid leukaemia (AML) is treated with intensive induction chemotherapy (IT) in medically fit patients. In general, obesity was identified as a risk factor for all-cause mortality, and there is an ongoing debate on its impact on outcome and optimal dosing strategy in obese AML patients. METHODS We conducted a registry study screening 7632 patients and assessed the impact of obesity in 1677 equally IT treated, newly diagnosed AML patients on the outcome (OS, EFS, CR1), comorbidities, toxicities and used dosing strategies. RESULTS Obese patients (BMI ≥ 30) displayed a significant inferior median OS (29.44 vs. 47.94 months, P = 0.015) and CR1 rate (78.7% vs. 84.3%, P = 0.015) without differences in median EFS (7.8 vs. 9.89 months, P = 0.3) compared to non-obese patients (BMI < 30). The effect was predominantly observed in older (≥60 years) patients. Obesity was identified as an independent risk factor for death, and obese patients demonstrated higher rates of cardiovascular or metabolic comorbidities. No differences for OS, EFS, CR1 or treatment-related toxicities were observed by stratification according to used dosing strategy or dose reduction. CONCLUSIONS In conclusion, this study identifies obesity as an independent risk factor for worse OS in older AML patients undergoing curative IT most likely due to obesity-related comorbidities and not to dosing strategy.
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Affiliation(s)
- Julius C Enßle
- Department of Medicine II, Hematology and Oncology, University Hospital Frankfurt, Goethe-University, Frankfurt am Main, Germany
| | - Sebastian Wolf
- Department of Medicine II, Hematology and Oncology, University Hospital Frankfurt, Goethe-University, Frankfurt am Main, Germany
| | - Sebastian Scheich
- Department of Medicine II, Hematology and Oncology, University Hospital Frankfurt, Goethe-University, Frankfurt am Main, Germany
| | - Sarah Weber
- Department of Medicine II, Hematology and Oncology, University Hospital Frankfurt, Goethe-University, Frankfurt am Main, Germany
| | - Michael Kramer
- Department of Internal Medicine I, University Hospital Dresden, Dresden, Germany
| | - Leo Ruhnke
- Department of Internal Medicine I, University Hospital Dresden, Dresden, Germany
| | | | | | - Stefan Krause
- Department of Hematology and Medical Oncology, University Hospital Erlangen, Erlangen, Germany
| | - Tim Sauer
- Department of Medicine V, Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Maher Hanoun
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, Essen, Germany
| | - Hans Christian Reinhardt
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, Essen, Germany
| | - Sabrina Kraus
- Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
| | - Martin Kaufmann
- Department of Hematology, Oncology and Palliative Medicine, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Mathias Hänel
- Department of Internal Medicine III, Chemnitz Hospital, Chemnitz, Germany
| | - Lars Fransecky
- Department of Internal Medicine II, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Andreas Burchert
- Department of Hematology, Oncology and Immunology, University Hospital Marburg, Marburg, Germany
| | - Andreas Neubauer
- Department of Hematology, Oncology and Immunology, University Hospital Marburg, Marburg, Germany
| | - Martina Crysandt
- Department of Internal Medicine IV, University Hospital RWTH Aachen, Aachen, Germany
| | - Edgar Jost
- Department of Internal Medicine IV, University Hospital RWTH Aachen, Aachen, Germany
| | - Dirk Niemann
- Department of Hematology/Oncology and Palliative Medicine, Ev. Stift St. Martin, Koblenz, Germany
| | - Kerstin Schäfer-Eckart
- Department of Internal Medicine 5, Hospital Nürnberg, Paracelsus Medizinische Privatuniversität, Nürnberg, Germany
| | - Gerhard Held
- Department of Internal Medicine I, Westpfalz Klinik, Kaiserslautern, Germany
| | - Ulrich Kaiser
- Department of Hematology and Oncology, St. Bernward Hospital, Hildesheim, Germany
| | - Maxi Wass
- Department of Internal Medicine IV, University Hospital Halle (Saale), Halle (Saale), Germany
| | - Markus Schaich
- Department of Hematology, Oncology and Palliative Medicine, Rems-Murr-Kliniken, Winnenden, Germany
| | - Carsten Müller-Tidow
- Department of Medicine V, Hematology, Oncology and Rheumatology, University Hospital Heidelberg, Heidelberg, Germany
| | - Uwe Platzbecker
- Department for Internal Medicine I, University Hospital Leipzig, Leipzig, Germany
| | - Claudia D Baldus
- Department of Internal Medicine II, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Martin Bornhäuser
- Department of Internal Medicine I, University Hospital Dresden, Dresden, Germany
| | - Christoph Röllig
- Department of Internal Medicine I, University Hospital Dresden, Dresden, Germany
| | - Hubert Serve
- Department of Medicine II, Hematology and Oncology, University Hospital Frankfurt, Goethe-University, Frankfurt am Main, Germany
| | - Björn Steffen
- Department of Medicine II, Hematology and Oncology, University Hospital Frankfurt, Goethe-University, Frankfurt am Main, Germany.
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2
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Yucel OK, Vural E, Alhan N, Vurgun S, Atas U, Yapar D, Alemdar MS, Karaca M, Iltar U, Salim O, Undar L. Lower Body Mass Index and Prognostic Nutritional Index Are Associated with Poor Posttransplant Outcomes in Lymphoma Patients Undergoing Autologous Stem Cell Transplantation. Oncology 2023; 101:753-764. [PMID: 37364535 DOI: 10.1159/000531576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023]
Abstract
INTRODUCTION Pretransplant inflammatory and nutritional status has not been widely explored in terms of its impact on autologous hematopoietic stem cell transplantation (auto-HSCT) outcomes in lymphoma patients. We aimed to evaluate the impact of body mass index (BMI), prognostic nutritional index (PNI), and C-reactive protein to albumin ratio (CAR) on auto-HSCT outcomes. METHODS We retrospectively analyzed 87 consecutive lymphoma patients who underwent their first auto-HSCT at the Adult Hematopoietic Stem Cell Transplantation Unit at Akdeniz University Hospital. RESULTS The CAR had no impact on posttransplant outcomes. PNI ≤50 was an independent prognostic factor for both shorter progression-free survival (PFS) (hazard ratio [HR] = 2.43, p = 0.025) and worse overall survival (OS) (HR = 2.93, p = 0.021), respectively. The 5-year PFS rate was significantly lower in patients with PNI ≤50 than in patients with PNI >50 (37.3% vs. 59.9%, p = 0.003). The 5-year OS rate in patients with PNI ≤50 was significantly low when compared with patients who had PNI >50 as well (45.5% vs. 67.2%, p = 0.011). Patients with BMI <25 had higher 100-day transplant-related mortality compared with patients with BMI ≥25 (14.7% vs. 1.9%, p = 0.020). BMI <25 was an independent prognostic factor associated with shorter PFS and OS (HR = 2.98 [p = 0.003], HR = 5.06 [p < 0.001], respectively). The 5-year PFS rate was significantly lower in patients with BMI <25 than patients with BMI ≥25 (40.2% vs. 53.7%, p = 0.037). Similarly, the 5-year OS rate in patients with BMI <25 was significantly inferior compared to patients with BMI ≥25 (42.7% vs. 64.7%, p = 0.002). CONCLUSION Our study confirms that lower BMI and CAR have negative impacts on auto-HSCT outcomes in lymphoma patients. Furthermore, higher BMI should not be considered an obstacle for lymphoma patients who need auto-HSCT; conversely, it could be an advantage for posttransplant outcomes.
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Affiliation(s)
- Orhan Kemal Yucel
- Department of Hematology and Stem Cell Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ece Vural
- Department of Hematology and Stem Cell Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Nurcan Alhan
- Department of Hematology and Stem Cell Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Sertac Vurgun
- Department of Hematology and Stem Cell Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Unal Atas
- Department of Hematology and Stem Cell Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Dilek Yapar
- Department of Public Health and Bioistatistics, Gazi University School of Medicine, Ankara, Turkey
| | | | - Mustafa Karaca
- Department of Medical Oncology, Antalya Research and Training Hospital, Antalya, Turkey
| | - Utku Iltar
- Department of Hematology and Stem Cell Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Ozan Salim
- Department of Hematology and Stem Cell Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Levent Undar
- Department of Hematology and Stem Cell Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
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3
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Jiménez-Cortegana C, Hontecillas-Prieto L, García-Domínguez DJ, Zapata F, Palazón-Carrión N, Sánchez-León ML, Tami M, Pérez-Pérez A, Sánchez-Jiménez F, Vilariño-García T, de la Cruz-Merino L, Sánchez-Margalet V. Obesity and Risk for Lymphoma: Possible Role of Leptin. Int J Mol Sci 2022; 23:ijms232415530. [PMID: 36555171 PMCID: PMC9779026 DOI: 10.3390/ijms232415530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 11/30/2022] [Accepted: 12/02/2022] [Indexed: 12/13/2022] Open
Abstract
Obesity, which is considered a pandemic due to its high prevalence, is a risk factor for many types of cancers, including lymphoma, through a variety of mechanisms by promoting an inflammatory state. Specifically, over the last few decades, obesity has been suggested not only to increase the risk of lymphoma but also to be associated with poor clinical outcomes and worse responses to different treatments for those diseases. Within the extensive range of proinflammatory mediators that adipose tissue releases, leptin has been demonstrated to be a key adipokine due to its pleotropic effects in many physiological systems and diseases. In this sense, different studies have analyzed leptin levels and leptin/leptin receptor expressions as a probable bridge between obesity and lymphomas. Since both obesity and lymphomas are prevalent pathophysiological conditions worldwide and their incidences have increased over the last few years, here we review the possible role of leptin as a promising proinflammatory mediator promoting lymphomas.
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Affiliation(s)
- Carlos Jiménez-Cortegana
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
- Department of Radiation Oncology, Weill Cornell Medical College, New York, NY 10065, USA
- Oncology Service, Department of Medicines, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Lourdes Hontecillas-Prieto
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
- Oncology Service, Department of Medicines, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Daniel J. García-Domínguez
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
- Oncology Service, Department of Medicines, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Fernando Zapata
- Oncology Service, Department of Medicines, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Natalia Palazón-Carrión
- Oncology Service, Department of Medicines, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - María L. Sánchez-León
- Oncology Service, Department of Medicines, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Malika Tami
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
- Oncology Service, Department of Medicines, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Antonio Pérez-Pérez
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Flora Sánchez-Jiménez
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Teresa Vilariño-García
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - Luis de la Cruz-Merino
- Oncology Service, Department of Medicines, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
- Correspondence: (L.d.l.C.-M.); (V.S.-M.)
| | - Víctor Sánchez-Margalet
- Department of Medical Biochemistry and Molecular Biology, School of Medicine, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
- Correspondence: (L.d.l.C.-M.); (V.S.-M.)
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4
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Abou-Ismail MY, Fraser R, Allbee-Johnson M, Metheny L, Ravi G, Ahn KW, Bhatt NS, Lazarus HM, de Lima M, El Jurdy N, Hematti P, Beitinjaneh AM, Nishihori T, Badawy SM, Sharma A, Pasquini MC, Savani BN, Sorror ML, Stadtmauer EA, Chhabra S. Does recipient body mass index inform donor selection for allogeneic haematopoietic cell transplantation? Br J Haematol 2022; 197:326-338. [PMID: 35286719 PMCID: PMC9675037 DOI: 10.1111/bjh.18108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 01/22/2023]
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 < 0.05] and MUD transplants at a BMI of 25-45 (HR, 1.61-3.47, 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.
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Affiliation(s)
- Mouhamed Yazan Abou-Ismail
- Division of Hematology & Hematologic Malignancies, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Raphael Fraser
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.,Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Mariam Allbee-Johnson
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Leland Metheny
- Adult Hematologic Malignancies & Stem Cell Transplant Section, Seidman Cancer Center, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Gayathri Ravi
- Division of Hematology/Oncology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kwang Woo Ahn
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.,Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Neel S Bhatt
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Hillard M Lazarus
- University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA
| | - Marcos de Lima
- The James Cancer Hospital and Solove Research Institute, The Ohio State University, Columbus, OH, USA
| | - Najla El Jurdy
- The Blood and Marrow Transplant Program, University of Minnesota, Minneapolis, MN, USA
| | - Peiman Hematti
- Division of Hematology/Oncology/Bone Marrow Transplantation, Department of Medicine, University of Wisconsin, Madison, WI, USA
| | - Amer M Beitinjaneh
- Division of Transplantation and Cellular Therapy, University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Taiga Nishihori
- Department of Blood & Marrow Transplant and Cellular Immunotherapy (BMT CI), Moffitt Cancer Center, Tampa, FL, USA
| | - Sherif M Badawy
- Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Akshay Sharma
- Department of Bone Marrow Transplantation and Cellular Therapy, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Marcelo C Pasquini
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.,Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Bipin N Savani
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Mohamed L Sorror
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.,Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | | | - Saurabh Chhabra
- CIBMTR® (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.,Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
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5
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Lucijanic M, Huzjan Korunic R, Sedinic M, Kovacevic S, Atic A, Pejsa V, Kusec R. Baseline and progressive adipopenia in newly diagnosed patients with diffuse large B-cell lymphoma with unfavorable features are associated with worse clinical outcomes. Leuk Lymphoma 2022; 63:1556-1565. [PMID: 35105266 DOI: 10.1080/10428194.2022.2034160] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We retrospectively analyzed perirenal and subcutaneous fat thickness and their dynamics from baseline to end-of-treatment computerized-tomography scans in a cohort of 118 newly diagnosed diffuse large B-cell lymphoma (DLBCL) patients with unfavorable features treated with R-DA-EPOCH regimen. Higher revised-international-prognostic-index (R-IPI) score was significantly associated with higher baseline perirenal and lower subcutaneous fat thickness. Up to 51% patients experienced perirenal and 40% subcutaneous fat-tissue loss during immunochemotherapy period. R-DA-EPOCH feasibility, toxicity and obtained response to therapy did not significantly differ regarding baseline perirenal and subcutaneous fat measurements whereas higher number of febrile-neutropenia cycles was associated with more pronounced subcutaneous fat loss. In multivariate-analyses subcutaneous fat loss of ≥6% (hazard-ratio (HR) =4.58, p < 0.001) and achieving response to therapy (HR = 0.03, p < 0.001) predicted overall-survival, and baseline subcutaneous fat thickness ≤24 mm (HR = 3.14, p = 0.023), baseline minimal perirenal fat thickness ≤8 mm (HR = 2.44, p = 0.042) and achieving response to therapy (HR = 0.04, p < 0.001) predicted progression-free-survival independently of each other.
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Affiliation(s)
- Marko Lucijanic
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Renata Huzjan Korunic
- School of Medicine, University of Zagreb, Zagreb, Croatia.,Department of Diagnostic and Interventional Radiology, Dubrava University Hospital, Zagreb, Croatia
| | - Martina Sedinic
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia
| | - Stjepan Kovacevic
- Department of Internal Medicine, General Hospital Slavonski Brod, Slavonski Brod, Croatia
| | - Armin Atic
- Department of Emergency Medicine, University Hospital Dubrava, Zagreb, Croatia
| | - Vlatko Pejsa
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Rajko Kusec
- Department of Hematology, University Hospital Dubrava, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
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6
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Price S, Kim Y. Body Composition Impacts Hematopoietic Stem Cell Transplant Outcomes in Both Autologous and Allogeneic Transplants: A Systematic Review. Nutr Cancer 2021; 74:2731-2747. [PMID: 34963380 DOI: 10.1080/01635581.2021.2020303] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
According to World Health Organization, over 50,000 hematopoietic stem cell transplants (HSCTs) are performed annually worldwide. Though HSCT can extend life-expectancy and improve disease-related health burdens, it is not without risks. Post-transplant overall survival is improving; therefore, it is imperative that factors contributing to or impeding further improvements are well understood. The purpose of this systematic review is to explore current data on body composition (specifically weight loss, BMI, obesity and sarcopenia) and the relation to HSCT outcomes. A literature search was conducted via PubMed and Web of Science databases. Key words included "body composition," "sarcopenia," "hematopoietic stem cell transplant," "malnutrition," "body mass index," and "obesity." Results indicated that 16 out of 18 analyzed studies found a statistically significant relationship between body composition, in particular higher BMI and weight loss, and at least one survival-related outcome variable (eg., non-relapse mortality, overall survival and/or relapse). Based on the findings of this review, body composition, whether evaluated before or during HSCT, can impact a wide variety of post-transplant outcomes. This speaks to the importance of evaluating patients pre-transplant, identifying potential risk factors for worsened outcomes, and providing immediate interventions in order to optimize transplant outcomes.
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Affiliation(s)
- Sarah Price
- Nutrition and Dietetics, Central Michigan University, Mt. Pleasant, Michigan, USA
| | - Yeonsoo Kim
- Nutrition and Dietetics, Central Michigan University, Mt. Pleasant, Michigan, USA
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7
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Lucijanic M, Huzjan Korunic R, Ivic M, Fazlic Dzankic A, Kusec R, Pejsa V. Perirenal and subcutaneous fat differently affect outcomes in newly diagnosed classical Hodgkin lymphoma patients. Hematol Oncol 2021; 39:575-579. [PMID: 33991435 DOI: 10.1002/hon.2887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/05/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Marko Lucijanic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Renata Huzjan Korunic
- University of Zagreb, School of Medicine, Zagreb, Croatia.,Department of Diagnostic and Interventional Radiology, Dubrava University Hospital, Zagreb, Croatia
| | - Marija Ivic
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia
| | | | - Rajko Kusec
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,University of Zagreb, School of Medicine, Zagreb, Croatia
| | - Vlatko Pejsa
- Hematology Department, University Hospital Dubrava, Zagreb, Croatia.,University of Zagreb, School of Medicine, Zagreb, Croatia
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