Open AccessChemotherapy Dose Adjustment for Obese Patients Undergoing Hematopoietic Stem Cell Transplantation: A Survey on Behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation
Author(s) -
ShemTov Noga,
Labopin Myriam,
Moukhtari Leila,
Ciceri Fabio,
Esteve Jordi,
Giebel Sebastian,
Gorin NorbertClaude,
Schmid Christopher,
Shimoni Avichai,
Nagler Ar,
Mohty Mohamad
Publication year - 2015
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2014-0187
Subject(s) - medicine , chemotherapy , hematopoietic stem cell transplantation , body surface area , transplantation , leukemia , bone marrow , dosing , body mass index , oncology , haematopoiesis , acute leukemia , stem cell , surgery , biology , genetics
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) designed 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 m 2 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 m 2 . 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 dose‐adjustment practice and, subsequently, to formulate a methodology for future prospective studies.