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Effects of chemotherapy dose reductions in overweight patients with acute myeloid leukaemia: A Danish nationwide cohort study

Overweight patients with cancer are frequently reduced in chemotherapy dose due to toxicity concerns, although previous studies have indicated that dose reduction (DR) of overweight patients results in comparable toxicity but may compromise overall survival (OS). Current evidence regarding DR in pat...

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Autores principales: Kristensen, Daniel Tuyet, Nielsen, Lars Børty, Jakobsen, Lasse Hjort Kyneb, Kristensen, Tove‐Christina Choe, Jepsen, Lene Østergaard, Schöllkopf, Claudia, Theilgaard‐Mönch, Kim, El‐Galaly, Tarec Christoffer, Roug, Anne Stidsholt, Severinsen, Marianne Tang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9825846/
https://www.ncbi.nlm.nih.gov/pubmed/36083781
http://dx.doi.org/10.1111/bjh.18448
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author Kristensen, Daniel Tuyet
Nielsen, Lars Børty
Jakobsen, Lasse Hjort Kyneb
Kristensen, Tove‐Christina Choe
Jepsen, Lene Østergaard
Schöllkopf, Claudia
Theilgaard‐Mönch, Kim
El‐Galaly, Tarec Christoffer
Roug, Anne Stidsholt
Severinsen, Marianne Tang
author_facet Kristensen, Daniel Tuyet
Nielsen, Lars Børty
Jakobsen, Lasse Hjort Kyneb
Kristensen, Tove‐Christina Choe
Jepsen, Lene Østergaard
Schöllkopf, Claudia
Theilgaard‐Mönch, Kim
El‐Galaly, Tarec Christoffer
Roug, Anne Stidsholt
Severinsen, Marianne Tang
author_sort Kristensen, Daniel Tuyet
collection PubMed
description Overweight patients with cancer are frequently reduced in chemotherapy dose due to toxicity concerns, although previous studies have indicated that dose reduction (DR) of overweight patients results in comparable toxicity but may compromise overall survival (OS). Current evidence regarding DR in patients with acute myeloid leukaemia (AML) is limited. To investigate the association between DR and outcome among overweight patients with AML we analysed a Danish nationwide cohort of overweight adult AML patients treated with remission induction chemotherapy. Among 536 patients identified, 10.1% were categorized as DR defined as 95% or less of full body surface area (BSA)‐based dose. Risk factors for DR were high body mass index (BMI) and BSA, therapy‐related AML and favourable cytogenetics. No significant differences were observed for rates of complete remission (CR), 30‐ and 90‐day mortality between DR and non‐DR patients. Furthermore, DR did not affect median relapse‐free survival (RFS) [DR, 14.5 (95% confidence interval, 9.0–41.7) months; non‐DR, 15.0 (12.3–19.3)] with an adjusted difference in five‐year restricted mean survival time (Δ5y‐RMST) of 0.2 (−8.4 to 8.8) months nor median OS (DR, 17.0 [11.9 to 45.5] months; non‐DR, 17.5 [14.8 to 20.5]) with an adjusted Δ5y‐RMST of 0.8 (−5.7 to 7.3) months. In conclusion, we found no statistically significant association between DR and outcomes among overweight patients with AML. However, we acknowledge the limited sample size and encourage further studies in this important subject.
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spelling pubmed-98258462023-01-09 Effects of chemotherapy dose reductions in overweight patients with acute myeloid leukaemia: A Danish nationwide cohort study Kristensen, Daniel Tuyet Nielsen, Lars Børty Jakobsen, Lasse Hjort Kyneb Kristensen, Tove‐Christina Choe Jepsen, Lene Østergaard Schöllkopf, Claudia Theilgaard‐Mönch, Kim El‐Galaly, Tarec Christoffer Roug, Anne Stidsholt Severinsen, Marianne Tang Br J Haematol Haematological Malignancy–Clinical Overweight patients with cancer are frequently reduced in chemotherapy dose due to toxicity concerns, although previous studies have indicated that dose reduction (DR) of overweight patients results in comparable toxicity but may compromise overall survival (OS). Current evidence regarding DR in patients with acute myeloid leukaemia (AML) is limited. To investigate the association between DR and outcome among overweight patients with AML we analysed a Danish nationwide cohort of overweight adult AML patients treated with remission induction chemotherapy. Among 536 patients identified, 10.1% were categorized as DR defined as 95% or less of full body surface area (BSA)‐based dose. Risk factors for DR were high body mass index (BMI) and BSA, therapy‐related AML and favourable cytogenetics. No significant differences were observed for rates of complete remission (CR), 30‐ and 90‐day mortality between DR and non‐DR patients. Furthermore, DR did not affect median relapse‐free survival (RFS) [DR, 14.5 (95% confidence interval, 9.0–41.7) months; non‐DR, 15.0 (12.3–19.3)] with an adjusted difference in five‐year restricted mean survival time (Δ5y‐RMST) of 0.2 (−8.4 to 8.8) months nor median OS (DR, 17.0 [11.9 to 45.5] months; non‐DR, 17.5 [14.8 to 20.5]) with an adjusted Δ5y‐RMST of 0.8 (−5.7 to 7.3) months. In conclusion, we found no statistically significant association between DR and outcomes among overweight patients with AML. However, we acknowledge the limited sample size and encourage further studies in this important subject. John Wiley and Sons Inc. 2022-09-09 2022-11 /pmc/articles/PMC9825846/ /pubmed/36083781 http://dx.doi.org/10.1111/bjh.18448 Text en © 2022 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Haematological Malignancy–Clinical
Kristensen, Daniel Tuyet
Nielsen, Lars Børty
Jakobsen, Lasse Hjort Kyneb
Kristensen, Tove‐Christina Choe
Jepsen, Lene Østergaard
Schöllkopf, Claudia
Theilgaard‐Mönch, Kim
El‐Galaly, Tarec Christoffer
Roug, Anne Stidsholt
Severinsen, Marianne Tang
Effects of chemotherapy dose reductions in overweight patients with acute myeloid leukaemia: A Danish nationwide cohort study
title Effects of chemotherapy dose reductions in overweight patients with acute myeloid leukaemia: A Danish nationwide cohort study
title_full Effects of chemotherapy dose reductions in overweight patients with acute myeloid leukaemia: A Danish nationwide cohort study
title_fullStr Effects of chemotherapy dose reductions in overweight patients with acute myeloid leukaemia: A Danish nationwide cohort study
title_full_unstemmed Effects of chemotherapy dose reductions in overweight patients with acute myeloid leukaemia: A Danish nationwide cohort study
title_short Effects of chemotherapy dose reductions in overweight patients with acute myeloid leukaemia: A Danish nationwide cohort study
title_sort effects of chemotherapy dose reductions in overweight patients with acute myeloid leukaemia: a danish nationwide cohort study
topic Haematological Malignancy–Clinical
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9825846/
https://www.ncbi.nlm.nih.gov/pubmed/36083781
http://dx.doi.org/10.1111/bjh.18448
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