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Obesity Associations with Chronic Graft-Versus-Host Disease
Valentina Ardila1, Lynn Onstad2, Paul Carpenter3
1Hematology and Oncology Training Program, Sylvester Comprehensive Cancer Center | University of Miami | Jackson Health System, Miami, Florida.
Transplantation and Cellular Therapy
|September 25, 2025
Summary
Obesity is linked to worse quality of life in patients with chronic graft-versus-host disease (GVHD). However, obesity did not significantly impact GVHD severity, treatment response, or survival outcomes in this study population.
Area of Science:
- Hematology
- Immunology
- Oncology
Background:
- Obesity is a growing concern, associated with inflammation and poorer disease outcomes.
- Preclinical data suggest obesity negatively impacts graft-versus-host disease (GVHD).
- Clinical data on obesity's effect on allogeneic hematopoietic cell transplantation (HCT) and chronic GVHD are limited and conflicting.
Purpose of the Study:
- To investigate the association of obesity with organ involvement, severity, and treatment response in chronic GVHD.
- To evaluate the impact of obesity on survival outcomes (overall survival, nonrelapse mortality, failure-free survival) and quality of life in chronic GVHD patients.
Main Methods:
- Retrospective analysis of 487 patients with newly diagnosed chronic GVHD from 2007-2019.
- Obesity defined as body mass index (BMI) ≥ 30.
- Comparison of chronic GVHD characteristics, treatment response, survival, and quality of life between obese and nonobese patients.
Main Results:
- 114 (23.4%) patients were classified as obese (BMI ≥ 30).
- Obesity was associated with diabetes as a comorbidity but not with differences in GVHD grade, organ involvement, or treatment response.
- Chronic lung GVHD was more frequent in obese patients (P = .047), but survival outcomes (OS, NRM, FFS) did not differ significantly.
- Obese patients reported greater symptom burden and worse quality of life at enrollment and 6 months post-enrollment.
Conclusions:
- Obesity is associated with diminished quality of life in allogeneic HCT recipients with chronic GVHD.
- Obesity did not significantly affect chronic GVHD phenotypes, treatment responsiveness, or survival outcomes in this cohort.
- Further research using detailed body composition measures is warranted to elucidate obesity's role in chronic GVHD.
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