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@ARTICLE{Dietrich:126435,
      author       = {S. Dietrich and A. Radujkovic and F. Stölzel and C. S.
                      Falk and A. Benner$^*$ and M. Schaich and M. Bornhäuser and
                      G. Ehninger and A. Krämer$^*$ and U. Hegenbart and A. D. Ho
                      and P. Dreger and T. Luft},
      title        = {{P}retransplant metabolic distress predicts relapse of
                      acute myeloid leukemia after allogeneic stem cell
                      transplantation.},
      journal      = {Transplantation},
      volume       = {99},
      number       = {5},
      issn         = {0041-1337},
      address      = {Hagerstown, Md.},
      publisher    = {Lippincott Williams $\&$ Wilkins},
      reportid     = {DKFZ-2017-02464},
      pages        = {1065 - 1071},
      year         = {2015},
      abstract     = {The impact of nutritional status on outcome of allogeneic
                      stem cell transplantation (alloSCT) is controversial. This
                      study investigates the influence of pretransplant weight
                      loss and serologic indicators of nutritional homeostasis on
                      relapse and death of acute myeloid leukemia (AML) after
                      alloSCT.Pretransplant weight loss along with serum levels of
                      total serum protein (TSP), albumin, C-reactive protein, and
                      leptin were collected retrospectively in a training cohort
                      (n = 149) and correlated with clinical outcome. Metabolic
                      risk groups were defined and tested in an independent
                      validation cohort (n = 167).We identified pretransplant
                      weight loss and TSP as strong independent predictors of
                      relapse and death. Patients in the metabolic high-risk group
                      (low TSP and weight loss) had an increased risk for relapse
                      (P = 0.0002) and death (P = 0.002), but a similar risk for
                      acute graft-versus-host disease. Weight loss coincided with
                      reduced pretransplant serum leptin levels. The adverse
                      influence of weight loss and high metabolic risk on relapse
                      and overall survival could be confirmed in the validation
                      cohort and similarly in patients with less than or more than
                      $5\%$ blasts before alloSCT. Multivariate analysis of both
                      cohorts revealed a hazard ratio for relapse of 7.78
                      (2.59-23.36, P = 0.0003) in the metabolic high risk
                      group.Altered nutritional homeostasis before alloSCT
                      correlates with recurrence of AML after transplantation.
                      Studies addressing pretransplant nutritional interventions
                      to reduce AML relapse rates are warranted.},
      keywords     = {Blood Proteins (NLM Chemicals) / Leptin (NLM Chemicals)},
      cin          = {C060 / G330},
      ddc          = {610},
      cid          = {I:(DE-He78)C060-20160331 / I:(DE-He78)G330-20160331},
      pnm          = {317 - Translational cancer research (POF3-317)},
      pid          = {G:(DE-HGF)POF3-317},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:25340610},
      doi          = {10.1097/TP.0000000000000471},
      url          = {https://inrepo02.dkfz.de/record/126435},
}