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Impact of obesity on GvHD risk after allo-HCT
By Ella Dixon
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Obesity is increasing in prevalence and can lead to increased inflammation and worsened outcomes in patients with hematologic malignancies.1 However, previous studies have shown conflicting results on the association between obesity and risk of GvHD. A retrospective cohort analysis conducted at the Cleveland Clinic assessed the impact of obesity on GvHD risk in patients who underwent allo-HCT for AML and MDS between January 2010 and December 2021. BMI was calculated pre-HCT and post-HCT, and patients were categorized as obese (BMI ≥30 kg/m²) or non-obese (BMI <30 kg/m²).1 Results were published in by Ardila et al.1 in Transplantation and Cellular Therapy. |
| Key learnings |
| The study found no significant difference in the incidence of acute (42% vs 43%) or chronic (29% vs 30%) GvHD between obese and non-obese patients. |
| Obese patients had lower rates of GI involvement in chronic GvHD (28% vs 48%; p = 0.01). Numerically higher rates of skin (63.8% vs 56.4%), mouth (44.8% vs 34.7%), and eye (34.5% vs 26.7%) involvement were observed in obese patients vs non-obese patients. |
| There were no significant differences in OS, NRM, or relapse rates between obese and non-obese patients post HCT. While not statistically significant, patients with obesity showed a trend toward more severe chronic GvHD vs non-obese patients (37.5% vs 29.2%). |
| The lower rates of GI involvement in obese patients suggest potential immunological or microbiome-related differences, warranting further investigation. Future research should explore body composition beyond BMI, including the role of adipose tissue in inflammation and GvHD pathogenesis. |
Abbreviations: allo-HCT, allogeneic hematopoietic cell transplant; AML, acute myeloid leukemia; BMI, body mass index; GI, gastrointestinal; GvHD, graft-versus-host disease; MDS, myelodysplastic syndromes; NRM, non-relapse mortality; OS, overall survival.
- Ardila V, Li H, Brunstein C, et al. Impact of Obesity on GVHD in Patients Undergoing Allogeneic Hematopoietic Cell Transplant for Hematologic Malignancies. Transplant Cell Ther. 2025; online ahead of print. DOI: 10.1016/j.jtct.2025.01.881
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