{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T04:40:05Z","timestamp":1751604005714,"version":"3.41.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T00:00:00Z","timestamp":1751587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>The prognostic significance of body mass index (BMI) in elderly acute myeloid leukemia (AML) patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) remains controversial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study analyzed 142 AML patients aged \u226550 years receiving allo-HCT (2013-2022), stratified by Chinese BMI criteria: low BMI (&amp;lt;24 kg\/m\u00b2, n = 83) vs. high BMI (\u226524 kg\/m\u00b2, n = 59).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median pre-transplant BMI was 23.63 (IQR, 22.07-25.78) kg\/m\u00b2. Multivariate analysis identified BMI &amp;lt;24 kg\/m\u00b2 as an independent risk factor for inferior OS (HR=1.80, p=0.037) and GRFS (HR=2.00, p = 0.003). Although BMI did not correlate with relapse, long-term non-relapse mortality (NRM), or the incidence of acute and chronic graft versus host disease (GVHD), the one-year NRM was significantly higher in the low BMI group compared to the high BMI group (p = 0.006). Subgroup analysis revealed that high-risk patients [not complete remission (NR) or CR but minimal residual disease (MRD)-positive) with low BMI had markedly reduced 3-year OS (20.87% vs. 57.69%, p=0.006), whereas no difference was observed in low-risk (CR\/MRD-negative) patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Pre-transplant BMI independently predicts inferior survival in older adults with AML undergoing allo-HCT. These findings highlight the need for BMI-guided nutritional interventions, especially for high-risk older patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1586523","type":"journal-article","created":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T04:10:28Z","timestamp":1751602228000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of pre-transplant body mass index on outcomes in AML patients aged \u2265 50 years after allogeneic hematopoietic cell 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