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Pediatric hematopoietic cell transplantation: Longitudinal trends in body mass index and outcomes
Author(s) -
Dang Brian Norman,
Wilhalme Holly,
Ch'ng James,
De Oliveira Satiro,
Bowles LaVette,
Moore Theodore Bruce
Publication year - 2020
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/petr.13844
Subject(s) - medicine , overweight , body mass index , transplantation , obesity , population , hematopoietic stem cell transplantation , retrospective cohort study , pediatrics , environmental health
Pediatric recipients of HCT may have a high susceptibility for overweight and obesity, and obesity may negatively impact post‐transplant mortality and survival. This is a single‐center retrospective analysis of 297 pediatric patients who received HCT between 2005 and 2018. Patients were classified as UW, NW, OW, or OB based on age‐adjusted BMI. A mixed‐effects linear regression model controlling for patient, disease, and transplant‐related characteristics was used to trend weight longitudinally. Comparisons were made between weight category and post‐transplant outcomes. In the pretransplant period, 5.4%, 54.5%, 22.2%, and 17.8% of patients were UW, NW, OW, and OB, respectively. Five years post‐transplantation, those numbers were 10.6%, 48.2%, 16.5%, and 24.7%. Overall, BMI increased 0.00094 ± 0.0001 kg/m 2 each day post‐transplant ( P < .001), with older individuals demonstrating greater rates of increase. Further, there was a larger BMI increase in patients without TBI compared with those who received TBI (1.29 ± 0.49, P = .008). Rates of acute GVHD, chronic GVHD, and viral infections, in addition to time to platelet and neutrophil engraftment and 5‐year survival estimates, were not significantly different based on pretransplant BMI. Overweight and obese individuals had poorer 5‐year survival based on 100‐day post‐transplant BMI ( P = .02). Overall, pediatric HCT recipients are at risk of developing obesity, which is associated with decreased survival. Adolescents and young adults demonstrate the highest risk of weight gain, representing a vulnerable population that requires close monitoring, additional interventions, and further research.