TY - JOUR
T1 - Chemotherapy dose adjustment for obese patients undergoing hematopoietic stem cell transplantation
T2 - A survey on behalf of the acute leukemia working party of the European society for blood and marrow transplantation
AU - Shem-Jov, Noga
AU - Labopin, Myriam
AU - Moukhtari, Leila
AU - Ciceri, Fabio
AU - Esteve, Jordi
AU - Giebel, Sebastian
AU - Gorin, Norbert Claude
AU - Schmid, Christopher
AU - Shimoni, Avichai
AU - Nagler, Arnon
AU - Mohty, Mohamad
N1 - Publisher Copyright:
© AlphaMed Press 2015.
PY - 2015
Y1 - 2015
N2 - Background. Appropriate chemotherapy dosing for obese patients with malignant diseases is a significant challenge because limiting chemotherapy doses in these patients may negatively influence outcome. There is a paucity of information addressing high-dose chemotherapy in obese patients undergoing hematopoietic stem cell transplantation (HSCT).Methods. The Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT) de- signed an electronic survey to assess current practice of dose adjustment of chemotherapy in obese patients undergoing HSCT.Results. A total of 56 EBMT centers from 27 countries responded to the online survey. Overall, 45 centers declared that they routinely adjust chemotherapy doses for obese patients (80.5%), and only 11 (19.5%) declared they do not adjust dose. Among the former group, most used body mass index as the parameter for defining obesity (28 centers, 62%). The method for determining the weight for chemotherapy calculation was actual body weight (ABW) in 16 centers, ideal body weight (IBW) in 10 centers, IBW plus 25% of the difference between IBW and ABW in 16 centers, and other methods for the rest. Among centers that used dose adjustment, 44% also capped the dose at 2 m2 for a chemotherapy dose based on body surface area (BSA), whereas 56% did not cap. Interestingly, most of the centers (9 of 11) that did not adjust dose for weight also did not cap the BSA at 2 m2.Conclusion. This EBMT survey revealed large diversity among transplant centers regarding dose-adjustment practice for high-dose conditioning chemotherapy. Our next step is to analyze outcomes of transplantation according to doseadjustment practice and, subsequently, to formulate a methodology for future prospective studies.
AB - Background. Appropriate chemotherapy dosing for obese patients with malignant diseases is a significant challenge because limiting chemotherapy doses in these patients may negatively influence outcome. There is a paucity of information addressing high-dose chemotherapy in obese patients undergoing hematopoietic stem cell transplantation (HSCT).Methods. The Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT) de- signed an electronic survey to assess current practice of dose adjustment of chemotherapy in obese patients undergoing HSCT.Results. A total of 56 EBMT centers from 27 countries responded to the online survey. Overall, 45 centers declared that they routinely adjust chemotherapy doses for obese patients (80.5%), and only 11 (19.5%) declared they do not adjust dose. Among the former group, most used body mass index as the parameter for defining obesity (28 centers, 62%). The method for determining the weight for chemotherapy calculation was actual body weight (ABW) in 16 centers, ideal body weight (IBW) in 10 centers, IBW plus 25% of the difference between IBW and ABW in 16 centers, and other methods for the rest. Among centers that used dose adjustment, 44% also capped the dose at 2 m2 for a chemotherapy dose based on body surface area (BSA), whereas 56% did not cap. Interestingly, most of the centers (9 of 11) that did not adjust dose for weight also did not cap the BSA at 2 m2.Conclusion. This EBMT survey revealed large diversity among transplant centers regarding dose-adjustment practice for high-dose conditioning chemotherapy. Our next step is to analyze outcomes of transplantation according to doseadjustment practice and, subsequently, to formulate a methodology for future prospective studies.
KW - Conditioning
KW - Dose adjustment
KW - Hematopoietic stem cell transplantation
KW - Obesity
UR - http://www.scopus.com/inward/record.url?scp=84921303387&partnerID=8YFLogxK
U2 - 10.1634/theoncologist.2014-0187
DO - 10.1634/theoncologist.2014-0187
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C2 - 25480827
AN - SCOPUS:84921303387
SN - 1083-7159
VL - 20
SP - 50
EP - 55
JO - Oncologist
JF - Oncologist
IS - 1
ER -