Outcomes for newly diagnosed patients with acute myeloid leukemia dosed on actual or adjusted body weight.

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.

• Authors: Whitney M Bray, Cory Bivona, Michelle Rockey, Dave Henry, Dennis Grauer, Sunil Abhyankar, Omar Aljitawi, Siddhartha Ganguly, Joseph McGuirk, Anurag Singh, Tara L Lin
• Journal: Cancer chemotherapy and pharmacology (Cancer Chemother Pharmacol) Vol. 76 Issue 4 Pg. 691-7 (Oct 2015) ISSN: 1432-0843 [Electronic] Germany
• PMID: 26231954 (Publication Type: Comparative Study, Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Anthracyclines
• Antineoplastic Agents
• Cytarabine

Topics

• Adult
• Aged
• Anthracyclines (administration & dosage, therapeutic use)
• Antineoplastic Agents (administration & dosage, therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage, therapeutic use)
• Body Mass Index
• Body Weight
• Cohort Studies
• Cytarabine (administration & dosage, therapeutic use)
• Drug Dosage Calculations
• Drug Resistance, Neoplasm
• Female
• Follow-Up Studies
• Humans
• Induction Chemotherapy
• Leukemia, Myeloid, Acute (complications, drug therapy, mortality, prevention & control)
• Male
• Middle Aged
• Obesity (complications)
• Overweight (complications)
• Recurrence
• Remission Induction
• Retrospective Studies
• Young Adult