Chemotherapy 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

Noga Shem-Jov, Myriam Labopin, Leila Moukhtari, Fabio Ciceri, Jordi Esteve, Sebastian Giebel, Norbert Claude Gorin, Christopher Schmid, Avichai Shimoni, Arnon Nagler, Mohamad Mohty

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)50-55
Number of pages6
JournalThe oncologist
Volume20
Issue number1
DOIs
Publication statusPublished - 2015

Keywords

  • Conditioning
  • Dose adjustment
  • Hematopoietic stem cell transplantation
  • Obesity

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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