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 journalArticlepeer-review

44 Scopus citations

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 - May 2014
Externally publishedYes

Keywords

  • Dosing
  • Hematopoietic cell transplantation
  • Obesity
  • Preparative regimens

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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