Conditioning Chemotherapy Dose Adjustment in Obese Patients

A Review and Position Statement by the American Society for Blood and Marrow Transplantation Practice Guideline Committee

Joseph Bubalo, Paul A. Carpenter, Navneet Majhail, Miguel Angel Perales, David I. Marks, Paul Shaughnessy, Joseph Pidala, Helen L. Leather, John Wingard, Bipin N. Savani

    Research output: Contribution to journalArticle

    28 Citations (Scopus)

    Abstract

    Hematopoietic stem cell transplantation (HCT) is a potentially life-saving therapy for patients with malignant and nonmalignant disease states. This article reviews the current published literature on the dosing of pharmacologic agents used for HCT preparative regimens with specific focus on the obese patient population. The review found that dose adjustments for obesity have, to date, been based empirically or extrapolated from published data in the nontransplantation patient population. As a result, the Committee determined that clear standards or dosing guidelines are unable to be made for the obese population because Level I and II evidence are unavailable at this time. Instead, the Committee provides a current published literature review to serve as a platform for conditioning agent dose selection in the setting of obesity. A necessary goal should be to encourage future prospective trials in this patient population because further information is needed to enhance our knowledge of the pharmacokinetics and pharmacodynamics of conditioning agents in the setting of obesity.

    Original languageEnglish (US)
    Pages (from-to)600-616
    Number of pages17
    JournalBiology of Blood and Marrow Transplantation
    Volume20
    Issue number5
    DOIs
    StatePublished - 2014

    Fingerprint

    Practice Guidelines
    Transplantation
    Bone Marrow
    Drug Therapy
    Obesity
    Hematopoietic Stem Cell Transplantation
    Population
    Pharmacokinetics
    Guidelines
    Therapeutics

    Keywords

    • Dosing
    • Hematopoietic cell transplantation
    • Obesity
    • Preparative regimens

    ASJC Scopus subject areas

    • Transplantation
    • Hematology
    • Medicine(all)

    Cite this

    Conditioning Chemotherapy Dose Adjustment in Obese Patients : A Review and Position Statement by the American Society for Blood and Marrow Transplantation Practice Guideline Committee. / Bubalo, Joseph; Carpenter, Paul A.; Majhail, Navneet; Perales, Miguel Angel; Marks, David I.; Shaughnessy, Paul; Pidala, Joseph; Leather, Helen L.; Wingard, John; Savani, Bipin N.

    In: Biology of Blood and Marrow Transplantation, Vol. 20, No. 5, 2014, p. 600-616.

    Research output: Contribution to journalArticle

    Bubalo, Joseph ; Carpenter, Paul A. ; Majhail, Navneet ; Perales, Miguel Angel ; Marks, David I. ; Shaughnessy, Paul ; Pidala, Joseph ; Leather, Helen L. ; Wingard, John ; Savani, Bipin N. / Conditioning Chemotherapy Dose Adjustment in Obese Patients : A Review and Position Statement by the American Society for Blood and Marrow Transplantation Practice Guideline Committee. In: Biology of Blood and Marrow Transplantation. 2014 ; Vol. 20, No. 5. pp. 600-616.
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    abstract = "Hematopoietic stem cell transplantation (HCT) is a potentially life-saving therapy for patients with malignant and nonmalignant disease states. This article reviews the current published literature on the dosing of pharmacologic agents used for HCT preparative regimens with specific focus on the obese patient population. The review found that dose adjustments for obesity have, to date, been based empirically or extrapolated from published data in the nontransplantation patient population. As a result, the Committee determined that clear standards or dosing guidelines are unable to be made for the obese population because Level I and II evidence are unavailable at this time. Instead, the Committee provides a current published literature review to serve as a platform for conditioning agent dose selection in the setting of obesity. A necessary goal should be to encourage future prospective trials in this patient population because further information is needed to enhance our knowledge of the pharmacokinetics and pharmacodynamics of conditioning agents in the setting of obesity.",
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