Objective:
To investigate the effect of
obesity on the
efficacy of allogeneic
hematopoietic stem cell transplantation.
Methods:
The clinical data of 81
patients who underwent allogeneic
hematopoietic stem cell transplantation from August 2017 to September 2020 in the First Affiliated
Hospital of Nanjing Medical
University were retrospectively analyzed. According to the
body mass index (BMI), the
patients were divided into the obese group (BMI≥28 kg/m 2, 11 cases) and the non-obese group (BMI<28 kg/m 2, 70 cases). The clinicopathological characteristics,
hematopoietic stem cell implantation, post-
transplantation complications,
survival and
recurrence were compared between the two groups. Univariate and multivariate
survival analyses were performed by using Cox proportional
hazards regression model.
Results:
The median follow-up
time of 81
patients was 280 d (8-1 218 d). The 1-year overall
survival (OS) rate was 77.9%, and the 1-year
progression-free survival (PFS) rate was 73.8%. The 1-year OS rates of the non-obese group and the obese group were 82.6% and 46.2% ( χ2 = 15.54, P<0.01), and the 1-year PFS rates were 82.1% and 36.4% ( χ2 = 15.56, P<0.01). The non-
recurrence mortality (NRM) rates of the non-obese group and the obese group were 7.1% and 32.7% ( χ2 = 6.463, P = 0.01), and the cumulative
recurrence rate was 11.5% and 42.9% ( χ2 = 8.146, P = 0.004). Between the non-obese group and the obese group, the median engraft
time of
neutrophils and
platelets, acute
graft-versus-host disease, chronic graft-versus-host disease,
hemorrhagic cystitis,
cytomegalovirus infection and
Epstein-Barr virus infection had no statistical difference ( P > 0.05). The result of
multivariate analysis showed that
obesity was an independent adverse influencing factor for OS of
patients with allogeneic
hematopoietic stem cell transplantation ( HR = 3.814, 95% CI 1.343-10.827, P = 0.012).
Conclusion:
Obesity is an important unfavorable factor that
affects patient's
survival after allogeneic
hematopoietic stem cell transplantation, and the improvement of the
efficacy and
survival of these
patients is worthy of further study.