Impact of pre-transplant body mass index on outcomes in AML patients aged ≥ 50 years after allogeneic hematopoietic cell transplantation
IntroductionThe prognostic significance of body mass index (BMI) in elderly acute myeloid leukemia (AML) patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) remains controversial.MethodsThis retrospective study analyzed 142 AML patients aged ≥50 years receiving allo-HCT (201...
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2025-07-01
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| author | Wenwen Guo Wenwen Guo Wenwen Guo Haixiao Zhang Haixiao Zhang Haixiao Zhang Hongye Gao Hongye Gao Hongye Gao Yawei Zheng Yawei Zheng Yawei Zheng Mingyang Wang Mingyang Wang Mingyang Wang Wenbin Cao Wenbin Cao Wenbin Cao Rongli Zhang Rongli Zhang Rongli Zhang Qiaoling Ma Qiaoling Ma Qiaoling Ma Yi He Yi He Yi He Weihua Zhai Weihua Zhai Weihua Zhai Donglin Yang Donglin Yang Donglin Yang Aiming Pang Aiming Pang Aiming Pang Sizhou Feng Sizhou Feng Sizhou Feng Mingzhe Han Mingzhe Han Mingzhe Han Yigeng Cao Yigeng Cao Yigeng Cao Erlie Jiang Erlie Jiang Erlie Jiang |
| author_facet | Wenwen Guo Wenwen Guo Wenwen Guo Haixiao Zhang Haixiao Zhang Haixiao Zhang Hongye Gao Hongye Gao Hongye Gao Yawei Zheng Yawei Zheng Yawei Zheng Mingyang Wang Mingyang Wang Mingyang Wang Wenbin Cao Wenbin Cao Wenbin Cao Rongli Zhang Rongli Zhang Rongli Zhang Qiaoling Ma Qiaoling Ma Qiaoling Ma Yi He Yi He Yi He Weihua Zhai Weihua Zhai Weihua Zhai Donglin Yang Donglin Yang Donglin Yang Aiming Pang Aiming Pang Aiming Pang Sizhou Feng Sizhou Feng Sizhou Feng Mingzhe Han Mingzhe Han Mingzhe Han Yigeng Cao Yigeng Cao Yigeng Cao Erlie Jiang Erlie Jiang Erlie Jiang |
| author_sort | Wenwen Guo |
| collection | DOAJ |
| description | IntroductionThe prognostic significance of body mass index (BMI) in elderly acute myeloid leukemia (AML) patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) remains controversial.MethodsThis retrospective study analyzed 142 AML patients aged ≥50 years receiving allo-HCT (2013-2022), stratified by Chinese BMI criteria: low BMI (<24 kg/m², n = 83) vs. high BMI (≥24 kg/m², n = 59).ResultsThe median pre-transplant BMI was 23.63 (IQR, 22.07-25.78) kg/m². Multivariate analysis identified BMI <24 kg/m² as an independent risk factor for inferior OS (HR=1.80, p=0.037) and GRFS (HR=2.00, p = 0.003). Although BMI did not correlate with relapse, long-term non-relapse mortality (NRM), or the incidence of acute and chronic graft versus host disease (GVHD), the one-year NRM was significantly higher in the low BMI group compared to the high BMI group (p = 0.006). Subgroup analysis revealed that high-risk patients [not complete remission (NR) or CR but minimal residual disease (MRD)-positive) with low BMI had markedly reduced 3-year OS (20.87% vs. 57.69%, p=0.006), whereas no difference was observed in low-risk (CR/MRD-negative) patients.DiscussionPre-transplant BMI independently predicts inferior survival in older adults with AML undergoing allo-HCT. These findings highlight the need for BMI-guided nutritional interventions, especially for high-risk older patients. |
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| institution | DOAJ |
| issn | 1664-3224 |
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| publishDate | 2025-07-01 |
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| series | Frontiers in Immunology |
| spelling | doaj-art-399af18ca3f2443eb82b05fb061f394e2025-08-20T02:43:25ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-07-011610.3389/fimmu.2025.15865231586523Impact of pre-transplant body mass index on outcomes in AML patients aged ≥ 50 years after allogeneic hematopoietic cell transplantationWenwen Guo0Wenwen Guo1Wenwen Guo2Haixiao Zhang3Haixiao Zhang4Haixiao Zhang5Hongye Gao6Hongye Gao7Hongye Gao8Yawei Zheng9Yawei Zheng10Yawei Zheng11Mingyang Wang12Mingyang Wang13Mingyang Wang14Wenbin Cao15Wenbin Cao16Wenbin Cao17Rongli Zhang18Rongli Zhang19Rongli Zhang20Qiaoling Ma21Qiaoling Ma22Qiaoling Ma23Yi He24Yi He25Yi He26Weihua Zhai27Weihua Zhai28Weihua Zhai29Donglin Yang30Donglin Yang31Donglin Yang32Aiming Pang33Aiming Pang34Aiming Pang35Sizhou Feng36Sizhou Feng37Sizhou Feng38Mingzhe Han39Mingzhe Han40Mingzhe Han41Yigeng Cao42Yigeng Cao43Yigeng Cao44Erlie Jiang45Erlie Jiang46Erlie Jiang47State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaState Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaHaihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin, ChinaTianjin Institutes of Health Science, Tianjin, ChinaIntroductionThe prognostic significance of body mass index (BMI) in elderly acute myeloid leukemia (AML) patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) remains controversial.MethodsThis retrospective study analyzed 142 AML patients aged ≥50 years receiving allo-HCT (2013-2022), stratified by Chinese BMI criteria: low BMI (<24 kg/m², n = 83) vs. high BMI (≥24 kg/m², n = 59).ResultsThe median pre-transplant BMI was 23.63 (IQR, 22.07-25.78) kg/m². Multivariate analysis identified BMI <24 kg/m² as an independent risk factor for inferior OS (HR=1.80, p=0.037) and GRFS (HR=2.00, p = 0.003). Although BMI did not correlate with relapse, long-term non-relapse mortality (NRM), or the incidence of acute and chronic graft versus host disease (GVHD), the one-year NRM was significantly higher in the low BMI group compared to the high BMI group (p = 0.006). Subgroup analysis revealed that high-risk patients [not complete remission (NR) or CR but minimal residual disease (MRD)-positive) with low BMI had markedly reduced 3-year OS (20.87% vs. 57.69%, p=0.006), whereas no difference was observed in low-risk (CR/MRD-negative) patients.DiscussionPre-transplant BMI independently predicts inferior survival in older adults with AML undergoing allo-HCT. These findings highlight the need for BMI-guided nutritional interventions, especially for high-risk older patients.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1586523/fullallogeneic hematopoietic cell transplantationelderlyacute myeloid leukemiabody mass indexsurvival |
| spellingShingle | Wenwen Guo Wenwen Guo Wenwen Guo Haixiao Zhang Haixiao Zhang Haixiao Zhang Hongye Gao Hongye Gao Hongye Gao Yawei Zheng Yawei Zheng Yawei Zheng Mingyang Wang Mingyang Wang Mingyang Wang Wenbin Cao Wenbin Cao Wenbin Cao Rongli Zhang Rongli Zhang Rongli Zhang Qiaoling Ma Qiaoling Ma Qiaoling Ma Yi He Yi He Yi He Weihua Zhai Weihua Zhai Weihua Zhai Donglin Yang Donglin Yang Donglin Yang Aiming Pang Aiming Pang Aiming Pang Sizhou Feng Sizhou Feng Sizhou Feng Mingzhe Han Mingzhe Han Mingzhe Han Yigeng Cao Yigeng Cao Yigeng Cao Erlie Jiang Erlie Jiang Erlie Jiang Impact of pre-transplant body mass index on outcomes in AML patients aged ≥ 50 years after allogeneic hematopoietic cell transplantation Frontiers in Immunology allogeneic hematopoietic cell transplantation elderly acute myeloid leukemia body mass index survival |
| title | Impact of pre-transplant body mass index on outcomes in AML patients aged ≥ 50 years after allogeneic hematopoietic cell transplantation |
| title_full | Impact of pre-transplant body mass index on outcomes in AML patients aged ≥ 50 years after allogeneic hematopoietic cell transplantation |
| title_fullStr | Impact of pre-transplant body mass index on outcomes in AML patients aged ≥ 50 years after allogeneic hematopoietic cell transplantation |
| title_full_unstemmed | Impact of pre-transplant body mass index on outcomes in AML patients aged ≥ 50 years after allogeneic hematopoietic cell transplantation |
| title_short | Impact of pre-transplant body mass index on outcomes in AML patients aged ≥ 50 years after allogeneic hematopoietic cell transplantation |
| title_sort | impact of pre transplant body mass index on outcomes in aml patients aged ≥ 50 years after allogeneic hematopoietic cell transplantation |
| topic | allogeneic hematopoietic cell transplantation elderly acute myeloid leukemia body mass index survival |
| url | https://www.frontiersin.org/articles/10.3389/fimmu.2025.1586523/full |
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