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Survival in overweight and underweight children undergoing hematopoietic stem cell transplantation

M White1, A J Murphy, A Hallahan

  • 1Department of Nutrition and Dietetics, Royal Children's Hospital, Herston, Queensland, Australia. Melinda_White@health.qld.gov.au

European Journal of Clinical Nutrition
|August 16, 2012
PubMed

Insights

Overweight children undergoing hematopoietic stem cell transplantation have reduced survival rates. Nutritional status impacts outcomes for pediatric cancer patients, with overweight status posing a significant risk post-transplant.

Area of Science:

  • Pediatric oncology
  • Hematopoietic stem cell transplantation
  • Nutritional science

Background:

  • Nutritional status is increasingly recognized as a factor influencing outcomes in pediatric cancer patients.
  • Understanding the impact of pre-transplant nutritional status on survival is crucial for optimizing patient care.

Purpose of the Study:

  • To investigate the association between pre-transplant nutritional status and overall survival in children undergoing hematopoietic stem cell transplantation.
  • To determine if weight categories (underweight, ideal weight, overweight) correlate with post-transplant survival rates.

Main Methods:

  • Retrospective audit of 113 pediatric patients undergoing autologous or allogeneic hematopoietic stem cell transplant.
  • Patients categorized into underweight, ideal weight, and overweight based on percent ideal body weight.
  • Overall post-transplant survival analyzed across weight categories, adjusting for relevant covariates.

Main Results:

  • Overweight patients (36%) demonstrated significantly lower survival rates compared to ideal-weight patients (Hazard Ratio 1.91).
  • Underweight patients (13%) did not show a statistically significant increase in mortality compared to ideal-weight patients (Hazard Ratio 1.47).
  • Key factors adjusted for included age, sex, donor source, conditioning therapy, and year of transplant.

Conclusions:

  • Pre-transplant overweight status is associated with decreased survival in children following hematopoietic stem cell transplantation.
  • Maintaining an ideal body weight prior to transplantation may be beneficial for improving survival outcomes in pediatric patients.
Abstract

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