Does recipient body mass index inform donor selection for allogeneic haematopoietic cell transplantation?

Mouhamed Yazan Abou-Ismail; Raphael Fraser; Mariam Allbee-Johnson; Leland Metheny; Gayathri Ravi; Kwang Woo Ahn; Neel S. Bhatt; Hillard M. Lazarus; Marcos de Lima; Najla El Jurdy; Peiman Hematti; Amer M. Beitinjaneh; Taiga Nishihori; Sherif M. Badawy; Akshay Sharma; Marcelo C. Pasquini; Bipin N. Savani; Mohamed L. Sorror; Edward A. Stadtmauer; Saurabh Chhabra

doi:10.1111/bjh.18108

Does recipient body mass index inform donor selection for allogeneic haematopoietic cell transplantation?

Mouhamed Yazan Abou-Ismail, Raphael Fraser, Mariam Allbee-Johnson, Leland Metheny, Gayathri Ravi, Kwang Woo Ahn, Neel S. Bhatt, Hillard M. Lazarus, Marcos de Lima, Najla El Jurdy, Peiman Hematti, Amer M. Beitinjaneh, Taiga Nishihori, Sherif M. Badawy, Akshay Sharma, Marcelo C. Pasquini, Bipin N. Savani, Mohamed L. Sorror, Edward A. Stadtmauer, Saurabh Chhabra^*

^*Corresponding author for this work

Pediatrics

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

It is not known whether obesity has a differential effect on allogeneic haematopoietic cell transplantation outcomes with alternative donor types. We report the results of a retrospective registry study examining the effect of obesity [body mass index (BMI) > 30] on outcomes with alternative donors (haploidentical related donor with two or more mismatches and receiving post-transplant cyclophosphamide [haplo] and cord blood (CBU)] versus matched unrelated donor (MUD). Adult patients receiving haematopoietic cell transplantation for haematologic malignancy (2013–2017) (N = 16 182) using MUD (n = 11 801), haplo (n = 2894) and CBU (n = 1487) were included. The primary outcome was non-relapse mortality (NRM). The analysis demonstrated a significant, non-linear interaction between pretransplant BMI and the three donor groups for NRM: NRM risk was significantly higher with CBU compared to haplo at BMI 25–30 [hazard ratio (HR) 1.66–1.71, p < 0.05] and MUD transplants at a BMI of 25–45 (HR, 1.61–3.47, p < 0.05). The results demonstrated that NRM and survival outcomes are worse in overweight and obese transplant recipients (BMI ≥ 25) with one alternative donor type over MUD, although obesity does not appear to confer a uniform differential mortality risk with one donor type over the other. BMI may serve as a criterion for selecting a donor among the three (MUD, haplo and CBU) options, if matched sibling donor is not available.

Original language	English (US)
Pages (from-to)	326-338
Number of pages	13
Journal	British Journal of Haematology
Volume	197
Issue number	3
DOIs	https://doi.org/10.1111/bjh.18108
State	Published - May 2022

Keywords

allogeneic cell transplant
alternative donor types
cord blood units
haploidentical
non-relapse mortality
obesity

ASJC Scopus subject areas

Hematology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1111/bjh.18108

Cite this

Abou-Ismail, M. Y., Fraser, R., Allbee-Johnson, M., Metheny, L., Ravi, G., Ahn, K. W., Bhatt, N. S., Lazarus, H. M., de Lima, M., El Jurdy, N., Hematti, P., Beitinjaneh, A. M., Nishihori, T., Badawy, S. M., Sharma, A., Pasquini, M. C., Savani, B. N., Sorror, M. L., Stadtmauer, E. A., & Chhabra, S. (2022). Does recipient body mass index inform donor selection for allogeneic haematopoietic cell transplantation? British Journal of Haematology, 197(3), 326-338. https://doi.org/10.1111/bjh.18108

@article{19efe9d7887a4227afeec7d7e31422af,

title = "Does recipient body mass index inform donor selection for allogeneic haematopoietic cell transplantation?",

abstract = "It is not known whether obesity has a differential effect on allogeneic haematopoietic cell transplantation outcomes with alternative donor types. We report the results of a retrospective registry study examining the effect of obesity [body mass index (BMI) > 30] on outcomes with alternative donors (haploidentical related donor with two or more mismatches and receiving post-transplant cyclophosphamide [haplo] and cord blood (CBU)] versus matched unrelated donor (MUD). Adult patients receiving haematopoietic cell transplantation for haematologic malignancy (2013–2017) (N = 16 182) using MUD (n = 11 801), haplo (n = 2894) and CBU (n = 1487) were included. The primary outcome was non-relapse mortality (NRM). The analysis demonstrated a significant, non-linear interaction between pretransplant BMI and the three donor groups for NRM: NRM risk was significantly higher with CBU compared to haplo at BMI 25–30 [hazard ratio (HR) 1.66–1.71, p < 0.05] and MUD transplants at a BMI of 25–45 (HR, 1.61–3.47, p < 0.05). The results demonstrated that NRM and survival outcomes are worse in overweight and obese transplant recipients (BMI ≥ 25) with one alternative donor type over MUD, although obesity does not appear to confer a uniform differential mortality risk with one donor type over the other. BMI may serve as a criterion for selecting a donor among the three (MUD, haplo and CBU) options, if matched sibling donor is not available.",

keywords = "allogeneic cell transplant, alternative donor types, cord blood units, haploidentical, non-relapse mortality, obesity",

author = "Abou-Ismail, {Mouhamed Yazan} and Raphael Fraser and Mariam Allbee-Johnson and Leland Metheny and Gayathri Ravi and Ahn, {Kwang Woo} and Bhatt, {Neel S.} and Lazarus, {Hillard M.} and {de Lima}, Marcos and {El Jurdy}, Najla and Peiman Hematti and Beitinjaneh, {Amer M.} and Taiga Nishihori and Badawy, {Sherif M.} and Akshay Sharma and Pasquini, {Marcelo C.} and Savani, {Bipin N.} and Sorror, {Mohamed L.} and Stadtmauer, {Edward A.} and Saurabh Chhabra",

note = "Funding Information: Leland Metheny III reports grants or contracts from Pfizer, consulting fees from Gamida Cell, payment or honoraria from Incyte, Takeda and, Tiaho, and participation on a Data Safety Monitoring Board or Advisory Board from Gamida Cell. Marcos de Lima reports grants from Pfizer, grants from Celgene, personal fees from Kadmon, personal fees from Pfizer, personal fees from Incyte, and personal fees from BMS, outside the submitted work. Akshay Sharma reports grants or contracts from CRISPR therapeutics, consulting fees from Spotlight Therapeutics and Medexus, Inc., payment or honoraria from Vindico Medical Education, and clinical trial site PI, and support paid to the institution from Novartis, CRISPR Therapeutics, and Vertex Pharmaceuticals. Taiga Nishihori reports research support for clinical trials to the institution from Novartis and research support (drug supply) for clinical trials to the institution from Karyopharm, both outside of the current work. Saurabh Chhabra reports payment or honoraria from GSK, and research support for clinical trials to the institution from Amgen, Janssen and Sanofi. Publisher Copyright: {\textcopyright} 2022 British Society for Haematology and John Wiley & Sons Ltd.",

year = "2022",

month = may,

doi = "10.1111/bjh.18108",

language = "English (US)",

volume = "197",

pages = "326--338",

journal = "British Journal of Haematology",

issn = "0007-1048",

publisher = "Wiley-Blackwell",