Yang J, Xue S-L, Zhang X, Zhou Y-N, Qin L-Q, Shen Y-P, Wu D-P
Department of Clinical Nutrition, The First Affiliated Hospital of Soochow University, Suzhou, China.
Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Dushu Lake Higher Education Town, Suzhou, China.
Eur J Clin Nutr. 2017 Jun;71(6):750-754. doi: 10.1038/ejcn.2016.225. Epub 2016 Nov 30.
BACKGROUND/OBJECTIVES: The present work was performed to investigate the association between body mass index (BMI) before transplantation and the overall survival (OS) of patients with allogeneic hematopoietic stem cell transplantation (allo-HSCT).
SUBJECTS/METHODS: Data from 310 adults who were diagnosed with acute leukemia and underwent allo-HSCT between March 2001 and December 2011 were analyzed. According to the suggested BMI categories for Asian population, patients with BMIs of ⩾23 and ⩾25 kg/m were identified as overweight and obese, respectively. Cox proportional hazards models was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).
The median follow-up time among the patients was 19.7 months (interquartile range=8.1-37.7). A total of 93 (34.8%) people died within the follow-up period. After adjusting for the potential confounders, normal-weight, overweight and obese patients showed significantly lower HRs than those of underweight patients, with a significant trend of OS improvement upon increasing BMI (P=0.019). Overweight and obese patients survived longer, with a significantly decreased HR by ~40% (HR=0.60; 95% CI: 0.38-0.95) compared with underweight and normal-weight patients.
An increased OS was seen in allo-HSCT patients with BMI⩾23 kg/m compared to those with lower BMI. Further work are still needed to investigate of the effects of BMI or body composition on the survival of allo-HSCT patients.
背景/目的：本研究旨在探讨移植前体重指数（BMI）与异基因造血干细胞移植（allo-HSCT）患者总生存期（OS）之间的关联。
对象/方法：分析了2001年3月至2011年12月期间310例诊断为急性白血病并接受allo-HSCT的成年患者的数据。根据亚洲人群建议的BMI分类，BMI≥23 kg/m和≥25 kg/m的患者分别被确定为超重和肥胖。采用Cox比例风险模型估计风险比（HR）及95%置信区间（CI）。
患者的中位随访时间为19.7个月（四分位间距=8.1-37.7）。共有93例（34.8%）患者在随访期内死亡。在调整潜在混杂因素后，正常体重、超重和肥胖患者的HR显著低于体重过轻的患者，且OS随BMI增加有显著改善趋势（P=0.019）。超重和肥胖患者生存期更长，与体重过轻和正常体重患者相比，HR显著降低约40%（HR=0.60；95%CI：0.38-0.95）。
与BMI较低的allo-HSCT患者相比，BMI≥23 kg/m的患者OS增加。仍需进一步研究BMI或身体成分对allo-HSCT患者生存的影响。
