The impact of overweight on renal toxicity in patients treated with dexamethasone, high-dose cytarabine, and cisplatin

Int J Hematol. 2020 Mar;111(3):396-400. doi: 10.1007/s12185-019-02779-8. Epub 2019 Nov 14.

Abstract

The combination of dexamethasone, high-dose cytarabine, and cisplatin (DHAP) is used as salvage chemotherapy for relapsed or refractory lymphoma. It includes the administration of cisplatin in a single dose of 100 mg/m2, and renal toxicity is a common adverse event. In this study, we retrospectively analyzed the risk factors for renal toxicity (≥ grade 2) in 74 patients who received DHAP as salvage chemotherapy. Regarding maximal renal toxicities, 38 (51.4%), 6 (8.1%), and 1 (1.4%) patients had grade 2, 3, and 4 toxicities, respectively. Multivariate analyses revealed that overweight (body mass index ≥ 25) was an independent predictive factor for renal toxicity of ≥ grade 2 (odds ratio [OR] 4.08, P = 0.032). A subgroup analysis for patients with diffuse large B cell lymphoma treated with DHAP as second-line therapy (n = 44) confirmed that overweight was an independent risk factor (OR 5.28, P = 0.049). In conclusion, we demonstrated that overweight was an independent risk factor for renal toxicity of ≥ grade 2 in patients who received DHAP. Further clinical studies will be needed to identify a method to decrease renal toxicities after the administration of cisplatin.

Keywords: Cisplatin; DHAP; Diffuse large B cell lymphoma; Renal toxicity; Salvage chemotherapy.

MeSH terms

  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / toxicity
  • Cisplatin / administration & dosage
  • Cisplatin / adverse effects*
  • Cisplatin / toxicity*
  • Cytarabine / administration & dosage
  • Cytarabine / adverse effects*
  • Cytarabine / toxicity
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects*
  • Dexamethasone / toxicity
  • Female
  • Humans
  • Kidney Tubules / drug effects
  • Lymphoma / drug therapy
  • Male
  • Overweight*
  • Retrospective Studies
  • Risk Factors
  • Salvage Therapy

Substances

  • Antineoplastic Agents
  • Cytarabine
  • Dexamethasone
  • Cisplatin