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Impact of body mass index on outcomes following allogeneic hematopoietic stem cell transplantation

Bone Marrow Transplantation (2025)Cite this article

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Allogeneic hematopoietic cell transplantation (allo-HCT) is a curative therapy for patients with acute leukemias (AL) and myelodysplastic syndromes (MDS). However, many factors can influence the early and long-term outcomes of allo-HCT, such as age, comorbidities, previous treatments, and patient-specific demographic factors. Obesity and undernutrition have both been associated with altered outcomes in cancer patients, including those undergoing allogeneic hematopoietic stem cell transplantation [1,2,3,4,5]. Obesity may complicate post-transplant recovery due to associated comorbidities like diabetes, cardiovascular disease, and several malignancies [1, 2]. Conversely, underweight status may reflect frailty and poor nutritional reserve, impacting immune recovery and survival following allo-HCT [3,4,5].

The role of body mass index (BMI) as an independent factor in several outcomes of allo-HCT has been explored in the past, including on overall survival, non-relapse mortality, graft-versus-host disease, and the risk of infection post-allo-HCT. However, prior studies have yielded inconsistent results in terms of the effect of BMI on these outcomes. In this study, we aimed to investigate the impact of BMI on outcomes following allo-HCT using the dataset provided by the Center for International Blood and Marrow Transplant Research (CIBMTR) registry.

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Data availability

The dataset is publicly available and can be accessed at: https://cibmtr.org/CIBMTR/Resources/Publicly-Available-Datasets.

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Funding

This paper did not receive any financial support. This dataset was collected by the Center for International Blood and Marrow Transplant Research (CIBMTR) which is supported primarily by the Public Health Service U24CA076518 from the National Cancer Institute; the National Heart, Lung, and Blood Institute; the National Institute of Allergy and Infectious Diseases; 75R60222C00011 from the Health Resources and Services Administration; N00014-23-1-2057 and N00014-24-1-2057 from the Office of Naval Research; NMDP; and the Medical College of Wisconsin.

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Authors and Affiliations

  1. Division of Hematology and Oncology, Moffitt Cancer Center, University of South Florida, Tampa, FL, USA

    Moazzam Shahzad

  2. The Mikael Rayaan Foundation Global Transplantation and Cellular Therapy Consortium, Kansas City, KS, USA

    Moazzam Shahzad, Aleenah Mohsin, Ibrahim Khamees, Aqeeb Ur Rehman, Muhammad Kashif Amin, Sibgha Gull Chaudhary, Iqra Anwer, Kayla Pfannenstiel, Al-Ola Abdallah, Mehdi Hamadani, Joseph P. Mcguirk & Muhammad Umair Mushtaq

  3. Division of Hematologic Malignancies & Cellular Therapeutics, University of Kansas Medical Center, Kansas City, KS, USA

    Muhammad Kashif Amin, Kayla Pfannenstiel, Al-Ola Abdallah, Joseph P. Mcguirk & Muhammad Umair Mushtaq

  4. U.S. Myeloma Innovations Research Collaborative, Kansas City, KS, USA

    Al-Ola Abdallah, Joseph P. Mcguirk & Muhammad Umair Mushtaq

  5. Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, WI, USA

    Mehdi Hamadani

Authors
  1. Moazzam Shahzad
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  2. Aleenah Mohsin
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  12. Muhammad Umair Mushtaq
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Contributions

MS and AM contributed to the methodology and data curation, performed the analysis, and revised the manuscript. IK wrote the manuscript. AUR contributed to design of the study, validation, and editing. MKA reviewed and edited the manuscript and revised it. SGC, IA, KP, AO, MM, and JPM contributed to the methodology and revised the manuscript for important intellectual content. MUM conceived and designed the project, supervised and administered the project, contributed to data curation and analysis, and reviewed the manuscript for important intellectual content. All authors contributed to the manuscript and fulfilled criteria per the uniform requirements set forth by the International Committee of Medical Journal Editors (ICJME) guidelines. All authors have reviewed and approved the final version of the manuscript.

Corresponding author

Correspondence to Muhammad Umair Mushtaq.

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Competing interests

No relevant conflicts of interest. MH has consultancy roles in Incyte Corporation, ADC Therapeutics, Pharmacyclics, Omeros, Genmab, Morphosys, Kadmon, Kite, Novartis, Abbvie, Legend, Gamida Cell, SeaGen, Autolus, Byondis, and Forte Biosciences Inc., and is on the speaker’s bureau for Sanofi Genzyme, AstraZeneca, BeiGene, and ADC Therapeutics. JPM has consulting and advisory roles in Bristol Myers Squibb, Kite, Novartis, AlloVir, Envision, Autolus, Nektar Therapeutics, CRISPR therapeutics, Caribou Bio, Sana Technologies, Legend Biotech, and Cargo Therapeutics. MUM has research funding from Iovance Biotherapeutics. The remaining authors declare no other commercial or financial relationships that could be construed as a potential conflict of interest.

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Shahzad, M., Mohsin, A., Khamees, I. et al. Impact of body mass index on outcomes following allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant (2025). https://doi.org/10.1038/s41409-025-02680-5

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