Tolerability of induction chemotherapy dosing practices in acute myeloid leukemia patients

For patients with high body surface areas (BSA), differing chemotherapy dosing strategies have been utilized in attempts to reduce toxicity. In a retrospective evaluation, we compared the effects of chemotherapy dosing in acute myeloid leukemia patients with high BSA (>2 m2) who received capped doses (n = 12) to those who received uncapped doses (n = 24), and to patients with BSA ≤ 2 m2 (n = 42). There were no statistically significant differences among groups (BSA ≤ 2 m2, BSA > 2 m2 capped, and BSA > 2 m2 uncapped) in the incidences of febrile neutropenia (85.7, 66.7, and 75.0%, respectively, p = 0.29), bacteremia (19.0, 8.3, and 16.7%, respectively, p = 0.68), mucositis (42.8, 50.0, and 41.7%, respectively, p = 0.88) or nausea/vomiting (47.6, 33.3, and 37.5, respectively, p = 0.57). Results suggest delivery of unadjusted chemotherapy based on actual body weight is likely safe in hematological malignancies.