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The Variance of Melphalan Doses Related to Kilogram of Body Weight and the Consequences


Authors: S. Vokurka
Authors‘ workplace: Hematologicko‑onkologické oddělení FN Plzeň
Published in: Klin Onkol 2010; 23(6): 452-453
Category: Short Communication

Overview

Melphalan is an important cytotoxic drug. The empirical practice of body surface area-based (BSA) dosing (mg/m2) of melphalan has been critically analyzed in several observations. BSA-based dosing leads to significant variability in doses administered per kilogram of body weight (mg/kg), contributes to increased oral toxicity and probably does not have any significant effect on treatment results within equally BSA (mg/m2) dosed melphalan regimens.

Key words:
melphalan – toxicity – autologous stem cells transplantation – mucositis


Sources

1. Gratwohl A. Principles of conditioning. In: Apperley J, Carreras E, Gluckman E. The 2008 revised edition of the ESH‑ EBMT Handbook on Haemopoietic Stem Cell Transplantation. Forum‑ Service Editore. Genova, Italy 2008: 129– 144.

2. Page RL, Macy DW, Thrall DE et al. Unexpected Toxicity Associated with Use of Body Surface Area for Dosing Melphalan in the Dog. Cancer Res 1998; 48: 288– 290.

3. Vassal G, Tranchand B, Valteau‑ Couanet D et al. Pharmacodynamics of tandem high‑dose melphalan with peripheral blood stem cell transplantation in children with neuroblastoma and medulloblastoma. Bone Marrow Transplant 2001; 27(5): 471– 477.

4. Grazziutti ML, Dong L, Miceli MH et al. Oral mucositis in myeloma patients undergoing melphalan‑based autologous stem cell transplantation: incidence, risk factors and a severity predictive model. Bone Marrow Transplant 2006; 38(7): 501– 506.

5. Costa LJ, Micallef IN, Inwards DJ et al. Effect of the dose per body weight of conditioning chemotherapy on severity of mucositis and risk of relapse after autologous haematopoietic stem cell transplantation in relapsed diffuse large B cell lymphoma. Br J Haematol 2008; 143(2): 268– 273.

6. Nath CE, Shaw PJ, Trotman J et al. Pharmacokinetics of melphalan in myeloma patients undergoing an autograft. Bone Marrow Transplant 2007; 40(7): 707– 708.

Labels
Paediatric clinical oncology Surgery Clinical oncology

Article was published in

Clinical Oncology

Issue 6

2010 Issue 6

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