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

  • Kento Umino
  • Kaoru Hatano
  • Shin-ichi Ochi
  • Harunobu Genda
  • Takashi Ikeda
  • Shin-ichiro Kawaguchi
  • Yumiko Toda
  • Shoko Ito
  • Takashi Nagayama
  • Kiyomi Mashima
  • Daisuke Minakata
  • Hirofumi Nakano
  • Ryoko Yamasaki
  • Kaoru Morita
  • Chihiro Yamamoto
  • Masahiro Ashizawa
  • Kazuya Sato
  • Iekuni Oh
  • Shin-ichiro Fujiwara
  • Ken Ohmine
  • Kazuo Muroi
  • Yoshinobu KandaEmail author
Original Article

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

Diffuse large B cell lymphoma Salvage chemotherapy DHAP Cisplatin Renal toxicity 

Notes

Acknowledgements

The authors declare no relevant conflict of interest with regard to the content of this manuscript.

Compliance with ethical standard

Conflict of interest

The authors declare that they have no conflict of interest. A summary of relevant information will be published with the manuscript.

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Copyright information

© Japanese Society of Hematology 2019

Authors and Affiliations

  • Kento Umino
    • 1
  • Kaoru Hatano
    • 1
  • Shin-ichi Ochi
    • 1
  • Harunobu Genda
    • 1
  • Takashi Ikeda
    • 1
  • Shin-ichiro Kawaguchi
    • 1
  • Yumiko Toda
    • 1
  • Shoko Ito
    • 1
  • Takashi Nagayama
    • 1
  • Kiyomi Mashima
    • 1
  • Daisuke Minakata
    • 1
  • Hirofumi Nakano
    • 1
  • Ryoko Yamasaki
    • 1
  • Kaoru Morita
    • 1
  • Chihiro Yamamoto
    • 1
  • Masahiro Ashizawa
    • 1
  • Kazuya Sato
    • 1
  • Iekuni Oh
    • 1
  • Shin-ichiro Fujiwara
    • 1
  • Ken Ohmine
    • 1
  • Kazuo Muroi
    • 1
  • Yoshinobu Kanda
    • 2
    Email author
  1. 1.Division of Hematology, Department of MedicineJichi Medical UniversityShimotsukeJapan
  2. 2.Division of Hematology, Department of MedicineJichi Medical UniversityShimotsukeJapan

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