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KMID : 0869620230400010047
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Journal of Korean Society of Hospital Pharmacists
2023 Volume.40 No. 1 p.47 ~ p.58
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Efficacy and Safety of Chemotherapy Dosed on Actual or Adjusted Body Weight in Obese Patients with Leukemia
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Park Ji-In
Lee Yu-Kyung
Koo Eun-Hyung
Lee So-Hee
Park Ae-Rryoung
Yoon Jeong-Yi
Kang Jin-Suk
Park Sylvia
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Abstract
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Background : There are no clear guidelines for setting anticancer drug doses in obese hematological cancer patients. Based on the reports that toxicity will not increase significantly, the weight application criteria for chemotherapy dose in acute leukemia was changed from the adjusted body weight (AdjBW) to the actual body weight (ABW) in August 2020. In this study, we compared the efficacy and safety between the AdjBW and ABW groups and evaluated the appropriateness of the criteria change.
Methods : From January 2019 to June 2021, the study was conducted on obese acute leukemia patients at Seoul St. Mary’s Hospital. The efficacy between the AdjBW and ABW groups was compared; whether each group reached complete remission (CR) and mortality within 30 days and recurrence within 6 months. The safety was evaluated by analyzing the recovery period of absolute neutrophils and platelets, bacteremia occurrence, and hospitalization period.
Results : There were no significant differences in the CR rate (84.6% vs 76.5%, p=0.502), mortality within 30 days (0% vs 4.8%, p=0.206), and recurrence within 6 months (6.7% vs 21.1%, p=0.24) between the groups after induction of chemotherapy. Recovery period of absolute neutrophils (21.51±4.2 days vs 20.69±6.48 days, p=0.412) and platelets (27.02±10 days vs 30.11±27 days, p=0.409), bacteremia occurrence (70.8% vs 56.9%, p=0.109), and hospitalization period (28.46±6.84 days vs 26.41±7.4 days, p=0.117) were not significantly different between the two groups, but the number of neutropenic fever was higher in the ABW group (1.60±1.08 times vs 1.12±0.89 times, p=0.01).
Conclusion : Preemptive anticancer dose reductions for obesity did not influence the composite endpoint of efficacy and safety. Therefore, changing the weight application criteria is considered appropriate from the point of view that it may help to obtain the maximum effect within the tolerable toxicity by patients.
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KEYWORD
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Leukemia, Obesity, Actual body weight, Adjusted body weight, Efficacy and Safety
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