To cap or not to cap: Chemotherapy dosing in obese adult hematology patients

摘要

Obesity, defined by the World Health Organization (WHO) as a body mass index (BMI) of >30 kg/m~2, is a risk factor for many cancers and may be associated with higher cancer-related mortality. In comparison to solid tumors, the influence of obesity on the prevalence, pathophysi-ology, treatment, and disease outcomes of hematological cancers such as lym-phoma, leukemia, and plasma cell disorders is less well defined. As the incidence of obesity increases (according to WHO projections, by 2015 more than 700 million adults worldwide will be obese),1 clinicians treating blood cancers are increasingly aware of the uncertainties and disparities with drug treatment within this group, especially in determining the most appropriate chemotherapy dosing algorithms that take into account the changes in anticancer drug pharma-cokinetics and pharmaco dynamics to optimize outcomes.