Whitney M Bray1, Cory Bivona2, Michelle Rockey3, Dave Henry4, Dennis Grauer5, Sunil Abhyankar6, Omar Aljitawi7, Siddhartha Ganguly8, Joseph McGuirk9, Anurag Singh10, Tara L Lin11. 1. Department of Pharmacy, The University of Kansas Hospital Cancer Center Pharmacy, 2330 Shawnee Mission Parkway, Mail Stop 5022, Westwood, KS, 66205, USA. wbray@kumc.edu. 2. Department of Pharmacy, University of Kansas School of Pharmacy, The University of Kansas Hospital Cancer Center Pharmacy, 2330 Shawnee Mission Parkway, Mail Stop 5022, Westwood, KS, 66205, USA. cbivona@kumc.edu. 3. Department of Pharmacy, University of Kansas School of Pharmacy, The University of Kansas Hospital Cancer Center Pharmacy, 2330 Shawnee Mission Parkway, Mail Stop 5022, Westwood, KS, 66205, USA. mrockey@kumc.edu. 4. University of Kansas School of Pharmacy, The University of Kansas Hospital, 3901 Rainbow Blvd, Mail Stop 4047, Kansas City, KS, 66160, USA. dhenry@kumc.edu. 5. University of Kansas School of Pharmacy, The University of Kansas Hospital, 3901 Rainbow Blvd, Mail Stop 4047, Kansas City, KS, 66160, USA. dgrauer@kumc.edu. 6. University of Kansas School of Medicine, The University of Kansas Cancer Center, 2330 Shawnee Mission Parkway, Mail Stop 5003, Westwood, KS, 66205, USA. sabhyankar@kumc.edu. 7. University of Kansas School of Medicine, The University of Kansas Cancer Center, 2330 Shawnee Mission Parkway, Mail Stop 5003, Westwood, KS, 66205, USA. oaljitawi@kumc.edu. 8. University of Kansas School of Medicine, The University of Kansas Cancer Center, 2330 Shawnee Mission Parkway, Mail Stop 5003, Westwood, KS, 66205, USA. sganguly@kumc.edu. 9. University of Kansas School of Medicine, The University of Kansas Cancer Center, 2330 Shawnee Mission Parkway, Mail Stop 5003, Westwood, KS, 66205, USA. jmcguirk@kumc.edu. 10. University of Kansas School of Medicine, The University of Kansas Cancer Center, 2330 Shawnee Mission Parkway, Mail Stop 5003, Westwood, KS, 66205, USA. asingh3@kumc.edu. 11. University of Kansas School of Medicine, The University of Kansas Cancer Center, 2330 Shawnee Mission Parkway, Mail Stop 5003, Westwood, KS, 66205, USA. tlin@kumc.edu.
Abstract
PURPOSE: Data from solid tumor malignancies suggest that actual body weight (ABW) dosing improves overall outcomes. There is the potential to compromise efficacy when chemotherapy dosages are reduced, but the impact of dose adjustment on clinical response and toxicity in hematologic malignancies is unknown. The purpose of this study was to evaluate the outcomes of utilizing a percent of ABW for acute myeloid leukemia (AML) induction chemotherapy dosing. METHODS: This retrospective, single-center study included 146 patients who received 7 + 3 induction (cytarabine and anthracycline) for treatment of AML. Study design evaluated the relationship between percentage of ABW dosing and complete response (CR) rates in patients newly diagnosed with AML. RESULTS: Percentage of ABW dosing did not influence CR rates in patients undergoing induction chemotherapy for AML (p = 0.83); nor did it influence rate of death at 30 days or relapse at 6 months (p = 0.94). When comparing patients dosed at 90-100 % of ABW compared to <90 % ABW, CR rates were not significantly different in patients classified as poor risk (p = 0.907). All favorable risk category patients obtained CR. CONCLUSIONS: Preemptive dose reductions for obesity did not influence CR rates for patients with AML undergoing induction chemotherapy and did not influence the composite endpoint of death at 30 days or disease relapse at 6 months.
PURPOSE: Data from solid tumor malignancies suggest that actual body weight (ABW) dosing improves overall outcomes. There is the potential to compromise efficacy when chemotherapy dosages are reduced, but the impact of dose adjustment on clinical response and toxicity in hematologic malignancies is unknown. The purpose of this study was to evaluate the outcomes of utilizing a percent of ABW for acute myeloid leukemia (AML) induction chemotherapy dosing. METHODS: This retrospective, single-center study included 146 patients who received 7 + 3 induction (cytarabine and anthracycline) for treatment of AML. Study design evaluated the relationship between percentage of ABW dosing and complete response (CR) rates in patients newly diagnosed with AML. RESULTS: Percentage of ABW dosing did not influence CR rates in patients undergoing induction chemotherapy for AML (p = 0.83); nor did it influence rate of death at 30 days or relapse at 6 months (p = 0.94). When comparing patients dosed at 90-100 % of ABW compared to <90 % ABW, CR rates were not significantly different in patients classified as poor risk (p = 0.907). All favorable risk category patients obtained CR. CONCLUSIONS: Preemptive dose reductions for obesity did not influence CR rates for patients with AML undergoing induction chemotherapy and did not influence the composite endpoint of death at 30 days or disease relapse at 6 months.
Entities:
Keywords:
Actual body weight; Acute myeloid leukemia; Adjusted body weight; Induction chemotherapy; Obesity
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