Nakao M, Chihara D, Niimi A, Ueda R, Tanaka H, Morishima Y, Matsuo K
1] Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Japan [2] Department of Medical Oncology and Immunology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Japan.
Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, 1-1 Kanokoden, Chikusa-ku, Japan.
Bone Marrow Transplant. 2014 Jan;49(1):66-72. doi: 10.1038/bmt.2013.128. Epub 2013 Aug 19.
The impact of being overweight on outcome after hematopoietic SCT (HSCT) is controversial. We performed meta-analyses to evaluate the impact of being overweight on acute graft-versus-host disease (aGVHD) risk and survival. Original data were obtained from MEDLINE, and studies that evaluated being overweight before transplantation in recipients as a risk factor for aGVHD or a prognostic factor for overall survival (OS) were extracted. Study-specific relative risks on the log scale comparing overweight with non-overweight patients were used to obtain a pooled RR with 95% confidence interval (CI). We identified 8 studies of aGVHD and 21 of OS. In allogeneic HSCT, the meta-analysis determined statistically significant associations of overweight recipients with aGVHD risk and OS. Meta-analysis of the 8 studies of aGVHD indicated that the RR for overweight to non-overweight patients was 1.186 (95% CI: 1.072-1.312). Regarding OS, meta-analysis of 11 allogeneic HSCT studies indicated that the RR for overweight to non-overweight patients was 1.163 (1.009-1.340). Our results indicate that being overweight before transplantation in recipients is associated with a high aGVHD rate and worse survival after allogeneic HSCT. Potential heterogeneity especially in adult/pediatric patients limits the interpretability of our finding. Further, well-designed large cohort studies are warranted.
超重对造血干细胞移植（HSCT）后结局的影响存在争议。我们进行了荟萃分析，以评估超重对急性移植物抗宿主病（aGVHD）风险和生存的影响。原始数据来自MEDLINE，并提取了评估移植前受者超重作为aGVHD风险因素或总生存（OS）预后因素的研究。使用对数尺度上比较超重与非超重患者的研究特异性相对风险来获得合并相对风险及95%置信区间（CI）。我们确定了8项关于aGVHD的研究和21项关于OS的研究。在异基因HSCT中，荟萃分析确定超重受者与aGVHD风险和OS之间存在统计学显著关联。对8项aGVHD研究的荟萃分析表明，超重患者与非超重患者的相对风险为1.186（95%CI：1.072 - 1.312）。关于OS，对11项异基因HSCT研究的荟萃分析表明，超重患者与非超重患者的相对风险为1.163（1.009 - 1.340）。我们的结果表明，移植前受者超重与异基因HSCT后aGVHD发生率高和生存较差相关。潜在的异质性，尤其是在成人/儿童患者中，限制了我们研究结果的可解释性。此外，需要设计良好的大型队列研究。
