Fleming D R, Rayens M K, Garrison J
Department of Medicine, University of Kentucky, Louisville 40292, USA.
Am J Med. 1997 Mar;102(3):265-8. doi: 10.1016/S0002-9343(96)00450-0.
To determine the impact of obesity on survival after high-dose therapy followed by allogeneic stem cell transplant in adults and children with various malignancies as well as metabolic disorders.
A matched case-controlled evaluation of 322 allogeneic patients from a single institution with a median follow-up of 296 and 120 days among nonobese and obese patients, respectively, was conducted between April 1983 and June 1995 at the University of Kentucky. The overall survival distributions among subsets defined as either obese or nonobese were measured.
The overall survival among the nonobese and obese was 35% and 20%, respectively (P = 0.0045). When patients were separated by age, the adult patients maintained this difference, while the children did not. When patients were stratified according to donor status, both the histocompatible and the nonhistocompatible adults had an inferior outcome among obese patients. The difference, however, was significant only among the histocompatible group (P = 0.0007). Causes of deaths were insignificantly distributed among both relapse as well as nonrelapse mechanisms.
Adult obese patients undergoing high-dose chemotherapy with stem cell rescue have a more adverse outcome. Both relapse and nonrelapse causes are responsible for the different outcome between obese and nonobese groups.
确定肥胖对接受大剂量治疗后进行异基因干细胞移植的成人和儿童各种恶性肿瘤及代谢紊乱患者生存的影响。
1983年4月至1995年6月在肯塔基大学对来自单一机构的322例异基因患者进行了配对病例对照评估，非肥胖和肥胖患者的中位随访时间分别为296天和120天。测量了定义为肥胖或非肥胖亚组的总生存分布。
非肥胖和肥胖患者的总生存率分别为35%和20%（P = 0.0045）。按年龄分组时，成年患者维持了这种差异，而儿童则没有。根据供体状态分层时，肥胖患者中组织相容性和非组织相容性成年患者的预后均较差。然而，这种差异仅在组织相容性组中显著（P = 0.0007）。死亡原因在复发和非复发机制中分布无显著差异。
接受大剂量化疗并进行干细胞救援的成年肥胖患者预后更差。复发和非复发原因均导致肥胖和非肥胖组之间的不同预后。
