Department of Pediatrics, Division of Pediatric Hematology/Oncology, Pediatric Stem Cell Transplant Program, Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, TN, USA.
Bone Marrow Transplant. 2011 Oct;46(10):1309-13. doi: 10.1038/bmt.2010.312. Epub 2010 Dec 13.
Obesity has become a pandemic, affecting both children and adults. We sought to determine the effect of obesity among 200 children who were prospectively enrolled on a multicenter cord blood transplant (CBT) trial. All patients received myeloablative preparative regimens. Children were classified into groups according to body mass index percentile. Normal weight was defined as body mass index between the 5th and 85th percentile (n=117), overweight between the 85th and 95th percentile (n=35) and obesity above 95th percentile (n=39) for age and gender. A total of 55 patients (27%) had AML, 113 patients (57%) had ALL and 32 patients (16%) had other malignant diseases. There was no evidence for a difference in all major characteristics among the groups. Time to neutrophil and platelet engraftment, TRM, risk of acute GVHD, disease-free survival and OS were not significantly different in overweight or obese patients compared with normal weight patients. There was a trend towards increased risk of chronic GVHD in obese patients (P=0.05) compared with normal weight patients. In conclusion, there is insufficient evidence from this sample that obesity has an effect on multiple outcomes after unrelated CBT in children with malignant diseases.
肥胖已成为一种全球性的问题，影响着儿童和成年人。我们旨在确定 200 名接受多中心脐带血移植（CBT）试验前瞻性入组的儿童中肥胖的影响。所有患者均接受了清髓性预处理方案。根据体重指数（BMI）百分位将儿童分为几组。体重正常定义为 BMI 处于第 5 至 85 百分位（n=117），超重为第 85 至 95 百分位（n=35），肥胖为超过第 95 百分位（n=39），按年龄和性别划分。共有 55 名患者（27%）患有 AML，113 名患者（57%）患有 ALL，32 名患者（16%）患有其他恶性疾病。各组之间在所有主要特征方面均无差异。中性粒细胞和血小板植入、TRM、急性移植物抗宿主病风险、无病生存和 OS 在超重或肥胖患者与体重正常患者之间无显著差异。与体重正常患者相比，肥胖患者慢性移植物抗宿主病的风险呈增加趋势（P=0.05）。总之，从本样本中得出的证据不足表明肥胖对患有恶性疾病的儿童进行无关供体 CBT 后的多个结局有影响。
