Obesity May Affect GVHD Risk After Stem Cell Transplant

Obesity may lead to an increased risk of moderate to severe chronic graft-versus-host disease (GVHD) in patients with blood cancer who underwent allogeneic hematopoietic cell transplantation, highlighting the importance of maintaining or working toward a healthy weight, explained Dr. Valentina Ardila.

Ardila, who is a second-year resident physician in the Internal Medicine Program at the Cleveland Clinic, recently discussed her team’s research on the impact of obesity on GVHD on patients who underwent an allogeneic hematopoietic cell transplant for treatment of their blood cancer.

READ MORE: Playing ‘Whac-a-Mole’ While Managing GVHD Symptoms After Transplantation

The research team analyzed data from 531 patients — 199 of whom were classified as obese (body mass index [BMI] of 30 or higher) and 332 who were classified as not obese (BMI of 29.9 or lower). Instances of acute or chronic GVHD were similar among the two groups. More specifically, among patients who experienced chronic GVHD (which, according to the American Cancer Society starts between 90 to 600 days after transplant), obese patients were more likely to experience skin involvement and have moderate-to-severe chronic GVHD.

Study findings also showed that treatment responses to medications used to treat chronic GVHD were no different among the obese and non-obese groups, those who were obese were more likely to receive second-line treatments and not respond to them.

Transcript

Patients should be aware that, as we have seen, obesity has lots of adverse cardiovascular outcomes, and now we're seeing that with bone marrow transplant and their long-term effects. It also seems to have an adverse effect.

So the key thing is, even though it sounds a little bit repetitive, it should be to keep a good diet and exercise as possible, given the disease you're suffering. But that is going to set you up for success for bone marrow transplant.
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