Impact of doxorubicin dose capping on the outcome of DLBCL patients with elevated body surface area

Caroline Gay (1) , Richard Delarue (2) , Noël Milpied (3) , Lucie Oberic (4) , Bertrand Coiffier (5, 6) , Sami Boussetta (7) , Corinne Haioun (8, 9, 10) , Hervé Tilly (11) , Gilles Salles (5) , Thierry Lamy (1) , Marie-Antoinette Lester , Roch Houot (12, 13)

1 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
2 Service d'immuno-hématologie pédiatrique [CHU Necker]
3 Hôpital Haut-Lévêque [CHU Bordeaux]
4 IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole
5 Service d’Hématologie [Centre Hospitalier Lyon Sud - HCL]
6 UNICANCER/CRCL - Centre de Recherche en Cancérologie de Lyon
7 The European Lymphoma Institute
8 Service d'hématologie clinique
9 UPEC Médecine - Université Paris-Est Créteil Val-de-Marne - Faculté de médecine
10 Unité des hémopathies lymphoïdes [CHU Henri Mondor]
11 GPL - Groupe d'étude des proliférations lymphoïdes
12 Service d'hématologie clinique
13 MICMAC - Microenvironment, Cell Differentiation, Immunology and Cancer

In 2012, the American Society of Clinical Oncology (ASCO) published guidelines regarding the dosing of chemotherapy for obese patients with cancer.1 In these patients, empiric dose reductions are often performed, usually by capping body surface area (BSA) at 2 m2 because of concerns regarding toxicity. However, there is no evidence that administering a full dose of chemotherapy in obese patients with solid cancer is associated with an increased toxicity.1 In addition, the ASCO guidelines highlight the negative impact on prognosis of reduced doses of chemotherapy in obese patients with solid tumors and thus recommend the use of full weight–based doses of cytotoxic chemotherapy, particularly in curable cancers.1 However, the impact of chemotherapy dosing has not been evaluated in non-Hodgkin lymphoma (NHL) patients with elevated BSA.In this study, we aimed to evaluate the impact of doxorubicin dose capping in patients with diffuse large B-cell lymphoma (DLBCL). DLBCL is a curable disease in which relative dose intensity has been described to be associated with treatment efficacy.2 However, clinicians may be concerned with the toxicity of high doses of anthracyclines in patients with elevated BSA.

Domains: Pharmacology; Cancer; Hematology

Caroline Gay, Richard Delarue, Noël Milpied, Lucie Oberic, Bertrand Coiffier, et al.. Impact of doxorubicin dose capping on the outcome of DLBCL patients with elevated body surface area. Blood, 2017, 129 (20), pp.2811-2813. ⟨10.1182/blood-2017-02-766147⟩. ⟨hal-01558813⟩