IMPACT OF OBESITY ON ALLOGENEIC STEM-CELL TRANSPLANT PATIENTS - A MATCHED CASE-CONTROLLED STUDY

PURPOSE: To determine the impact of obesity on survival after high-dos e therapy followed by allogeneic stem cell transplant in adults and ch ildren with various malignancies as well as metabolic disorders. PATIE NTS AND METHODS: A matched case-controlled evaluation of 322 allogenei c patients from a single institution with a median follow-up of 296 an d 120 days among nonobese and obese patients, respectively, was conduc ted between April 1983 and June 1995 at the University of Kentucky. Th e overall survival distributions among subsets defined as either obese or nonobese were measured. RESULTS: The overall survival among the no nobese and obese was 35% and 20%, respectively (P = 0.0045). When pati ents were separated by age, the adult patients maintained this differe nce, while the children did not. When patients were stratified;accordi ng to donor status, both the histocompatible and the nonhistocompatibl e 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 re lapse as well as nonrelapse mechanisms. CONCLUSION: Adult obese patien ts undergoing high-dose chemotherapy with stem cell rescue have a more adverse outcome. Both relapse and nonrelapse causes are responsible f or the different outcome between obese and nonobese groups. (C) 1997 b y Excerpta Medica, Inc.