Hematological toxicity of carboplatin for gynecological cancer according to body mass index.
OBJECTIVE
The aim of the present study was to analyze how patient weight affects the hematological toxicity of carboplatin and whether this toxicity is more prevalent in overweight patients.


METHODS
We performed a retrospective 2-year study of patients diagnosed with a gynecological cancer and whose treatment regimen contained carboplatin (AUC dose = 5 or 6) and paclitaxel (dose = 175 mg/m(2)) every 3 weeks (CP scheme). We recorded all severe hematological events (thrombocytopenia, neutropenia, and/or anemia grade III/IV) according to the CTCAE v4.03, as well as treatment modifications and the need for granulocyte colony-stimulating factors (G-CSF) and/or erythropoietin (EPO) or packed red blood cells (PRBC). Patients with a body mass index (BMI) ≥27 kg/m(2) were considered as overweight (OW) and those with a BMI <27 kg/m(2) were considered as normal weight (NW).


RESULTS
Fifty-two patients met the inclusion criteria (21 patients in the OW group, 31 patients in the NW group). The OW group showed a higher incidence of thrombocytopenia (95% confidence intervals (CI) 1.51-27.72; p < 0.02) and anemia (95% CI 1.06-33.63; p < 0.05). Moreover, this was reflected in a greater number of changes in the usual CP regimen (95% CI 2.19-44.32; p < 0.01). The need for G-CSF and/or EPO/PRBC was also significantly higher in the OW group (95% CI 1.08-12.16; p < 0.04).


CONCLUSIONS
Carboplatin dosing based on real weight in obese patients resulted in increased hematologic toxicity, mainly thrombocytopenia. Dose adjustment based on other descriptors of weight, such as adjusted weight, may be better tolerated by patients. However, future studies are needed to demonstrate not only better safety of carboplatin but also improved survival rates.
, Carretera Ofra S/N La Cuesta, San Cristóbal de La Laguna (Tenerife), 38320, Islas Canarias, Spain. fgunico@gmail.com.
Fernando
F
Gutierrez
, Carretera Ofra S/N La Cuesta, San Cristóbal de La Laguna (Tenerife), 38320, Islas Canarias, Spain.
Guillermo Antonio
GA
Gonzalez-de-la-Fuente
, Carretera Ofra S/N La Cuesta, San Cristóbal de La Laguna (Tenerife), 38320, Islas Canarias, Spain.
Gloria Julia
GJ
Nazco
, Carretera Ofra S/N La Cuesta, San Cristóbal de La Laguna (Tenerife), 38320, Islas Canarias, Spain.
Juana
J
Oramas
, Carretera Ofra S/N La Cuesta, San Cristóbal de La Laguna (Tenerife), 38320, Islas Canarias, Spain.
Norberto
N
Batista
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D015992:Body Mass Index; D016190:Carboplatin / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D005260:Female; D005833:Genital Neoplasms, Female / Q000097:blood / Q000188:drug therapy*; D006402:Hematologic Diseases / Q000097:blood / Q000139:chemically induced* / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D050177:Overweight / Q000097:blood / Q000378:metabolism*; D017239:Paclitaxel / Q000627:therapeutic use
D000970:Antineoplastic Agents; D016190:Carboplatin; D017239:Paclitaxel
Carboplatin; Hematological toxicity; Ovarian cancer