Examining the safety and efficacy of a chemotherapy dosing method in Allogeneic Stem Cell Transplant patients of extreme body size.
BACKGROUND
There is no consensus on a universal dosing method for calculating high-dose chemotherapy in allogeneic Stem Cell Transplant (SCT) patients. The Metropolitan Life (Met-Life) Insurance Company's weight-height tables have been used to determine body weight for chemotherapy dosing for SCT, however no formal study has been done to determine if the Met-Life weight- height tables can be used for chemotherapy dosing in SCT. We retrospectively studied the use of Met-Life weight-height tables for chemotherapy dosing in SCT. Our goal is to determine if patients with extremes of body size who had undergone an SCT and were dosed according to the Met-Life weight- height tables had an increase of Treatment Related Morbidity (TRM) or mortality or relapse.


METHODS
Patients were grouped into three different treatment regimens, cyclophosphamide/TBI, busulphan/cyclophosphamide, and AraC/cyclophosphamide/TBI. Patients in each treatment regimen were further divided into five equal groups based on weight. Treatment related morbidity and mortality was evaluated by comparing the lowest and highest quintiles to the middle quintiles within each treatment regimen.


RESULTS
Data from 262 patients was evaluated in this study. Overall, there was not an increase in TRM or mortality or in relapse in patients with extremes of body size.


CONCLUSIONS
The Met-Life weight-height tables could be used to dose patients undergoing allogeneic SCTs. Additional prospective studies would need to be done comparing other chemotherapy dosing methods with the Met-Life weight-height tables to further validate this conclusion.
Sriharsha
Lakshmi
L
Department of Pharmacy, University of Toronto, Princess Margaret Hospital, Ontario, Canada.
Lipton
Jeffrey H
JH
Pond
Greg
G
Ma
Clement
C
Raybardhan
Sumit
S
Messner
Hans A
HA
Seki
Jack T
JT
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D001835:Body Weight / Q000502:physiology*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D009767:Obesity, Morbid / Q000150:complications / Q000378:metabolism; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012015:Reference Standards; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult