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BEAM conditioning is well-tolerated and yields similar survival in obese and non-obese patients with lymphoma: no requirement for weight-based dose modifications

Bone Marrow Transplantation volume 52, pages 491–493 (2017)Cite this article

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High-dose BEAM (carmustine, etoposide, cytarabine and melphalan) chemotherapy is the most common conditioning regimen for autologous hematopoietic cell transplantation (AHCT) recipients with lymphoma.1 Despite widespread utilization of BEAM, there are limited data on the need for dose modifications in obese patients, resulting in center-specific and empiric adjustments.2, 3, 4 A guideline to dose BEAM in obese patients has become necessary as the obesity rate has doubled to >30% in the past few decades.5 Obese patients have relatively more lean body weight, bone mass and blood volume than non-obese patients, and obesity may affect renal and hepatic function and increase the volume of distribution for lipophilic drugs all of which may lead to altered drug pharmacokinetics.6

A variety of dosing strategies has been employed in obese patients including using total body weight (TBW), adjusted body weight or ideal body weight (IBW).7, 8 However, arbitrary dose reductions may lead to under-dosing and result in treatment failure. In this study, we report a cohort of patients prospectively treated with BEAM using TBW without weight-adjustment and compare short-term transplant outcomes focusing on toxicity and early disease control among non-obese versus obese patients.

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References

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Authors and Affiliations

  1. Blood and Marrow Transplantation Program, University of Minnesota Medical Center, Minneapolis, MN, USA

    C Fair, R Shanley, J Rogosheske, A Lazaryan, B McClune, C G Brunstein & V Bachanova

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  1. C Fair
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  2. R Shanley
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  3. J Rogosheske
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  4. A Lazaryan
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  5. B McClune
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  6. C G Brunstein
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  7. V Bachanova
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Correspondence to V Bachanova.

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The authors declare no conflict of interest.

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Fair, C., Shanley, R., Rogosheske, J. et al. BEAM conditioning is well-tolerated and yields similar survival in obese and non-obese patients with lymphoma: no requirement for weight-based dose modifications. Bone Marrow Transplant 52, 491–493 (2017). https://doi.org/10.1038/bmt.2016.316

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