Analysis of Correlation between Body Mass Index and the Incidence of Graft-Versus-Host Disease in Allogeneic Hematopoietic Stem Cell Transplantation

Graft-versus-host disease (GVHD) is a life-threatening complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Identifiying the probable risk factors can help the clinicians manage the consequences of GVHD. The main aim of this study was to analyze the correlation of body mass index (BMI) as a risk factor with the GVHD incidence. This retrospective study was conducted on 199 patients who received allo-HSCT during 2007-2017, as well as their donors. Almost all included patients received 10/10 human leukocyte antigen )HLA(-matched allogeneic stem cell transplants. The clinical data, including BMI, underlying disease and GVHD incidence, were collected from the clinical records. In the present study, GVHD was seen in 77 (38.6%) patients, including 59 acute and 18 chronic GVHD. The most frequent BMI range in both donors (35.5%) and recipients (45.2%) was between 18.5- 24.9 kg/m2. The transplants in which the BMI of donors were below 18.5 kg/m2 had 58% lower odds of GVHD incidence, compared to those with obese donors (CI: [0.21-0.85]; P = 0.05). Conversely, the donors with a BMI between 18.5 and 24.9 kg/m2 led to a 19% higher odds of GVHD incidence, especially acute GVHD, than transplants from donors with BMI above 30 kg/m2 (CI: [0.68-2.09]; P = 0.09). The recipients with a BMI between 18.5 and 24.9 kg/m2 had the odds of GVHD incidence 63% more than those with a BMI above 30 kg/m2 (CI: [0.89-3.06]; P= 0.3). The findings of the present study suggest the donor's BMI as a probable GVHD risk factor so that the BMI lower than 18.5 kg/m2 was statistically correlated with a decreased incidence of GVHD.