Association between body mass index and survival after hematopoietic stem cell transplantation

Han Sang Baek, Jong Hyuk Lee, Joonyub Lee, Seung Hwan Lee, Gi June Min, Sung Soo Park, Silvia Park, Sung Eun Lee, Byung Sik Cho, Ki Seong Eom, Yoo Jin Kim, Seok Lee, Hee Je Kim, Chang Ki Min, Seok Goo Cho, Jong Wook Lee, Jae Ho Yoon

Research output: Contribution to journalArticlepeer-review

Abstract

Background/Aims: The unclear relationship between body mass index (BMI) and post-hematopoietic stem cell transplantation (HSCT) mortality was investigated, including the impact of metabolic diseases. Methods: This retrospective study conducted at a Korean tertiary hospital (2009–2021) included patients who underwent HSCT. Patients were categorized as underweight (BMI < 18.5 kg/m2, n = 106), normal (BMI 18.5–22.9 kg/m2, n = 1,345), overweight (BMI 23.0–24.9 kg/m2, n = 980), or obese (BMI ≥ 25.0 kg/m2, n = 1,471). Diabetes mellitus (DM), hypertension, and dyslipidemia were identified by disease codes or medication prescriptions. A Cox proportional hazards model was used to analyze mortality risks. Results: Over 108 months, 29.8% (1,164/3,902) of the participants died. Patients with underweight had significantly higher mortality (adjusted HR 1.76, 95% CI 1.29–2.40, p < 0.001) than in those with normal BMI. Patients with overweight and obesity did not show increased mortality. Post-HSCT, DM significantly raised mortality risk (HR 3.36, 95% CI 2.86–3.94, p < 0.001), whereas newly diagnosed dyslipidemia was associated with lower mortality (HR 0.27, 95% CI 0.23–0.33, p < 0.001). Post-transplant hypertension had no significant impact on mortality (HR 1.10, 95% CI 0.95–1.28, p = 0.184). Conclusions: Post-HSCT, obesity is not a prognostic factor for poor survival; however, certain metabolic diseases have diverse effects on mortality.

Original languageEnglish
Pages (from-to)645-656
Number of pages12
JournalKorean Journal of Internal Medicine
Volume40
Issue number4
DOIs
StatePublished - Jul 2025

Bibliographical note

Publisher Copyright:
© 2025 The Korean Association of Internal Medicine.

Keywords

  • Body mass index
  • Hematopoietic stem cell transplantation
  • Mortality
  • Obesity
  • Underweight

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