Can BMI impact outcomes of children with acute leukemia who undergo a transplant?

This study aimed to investigate if body mass index can impact outcomes of children with acute leukemia undergoing stem cell transplantation.

This study concluded that being underweight at the time of transplant is associated with an increased risk of acute graft versus host disease in these patients. 

Body mass index (BMI) is an index that relates weight to height. A BMI of 16 to 18.5 indicates a person is underweight. A BMI of 18.5 to 25 indicates a person is normal weight. A BMI of 25 to 35 indicates a person is overweight and those with a BMI of 30 to 35 are classified as obese.

Umbilical cord blood transplants (UCBT) are used as treatment for children with acute leukemia (AL). Umbilical cord blood is rich in stem cells (immature blood cells). Acute graft versus host disease (aGvHD) is a complication of UCBT. It is a reaction of the donor cells against the patient’s tissues. It can sometimes result in death.

It was not known what impact BMI had on survival of children with AL undergoing transplant.

This study involved 855 patients aged 2 to 20 with AL who underwent UCBT. Patients were classified into four groups based on BMI. 61% of patients were in the normal group. 11% were in the underweight group. 16% were in the overweight group. 12% were in the obese group. All patients received UCBT after myeloablative conditioning regimen (high-dose chemotherapy).

35% of all patients experienced aGvHD. 46% of the underweight group experienced aGvHD. 34% of the normal group had aGvHD. 36% of the overweight group had aGvHD. 27% of the obese group had aGvHD. Patients in the underweight group were 61% more likely to experience aGvHD when compared to patients in the normal BMI group.  

This study concluded that patients who were underweight at the time of transplant had an increased risk of aGvHD when compared to the normal BMI group.

Discuss BMI and UCBT with your physician.