Impact of doxorubicin dose capping on the outcome of DLBCL patients with elevated body surface area

International audience; In 2012, the American Society of Clinical Oncology (ASCO) published guidelines regarding the dosing of chemotherapy for obese patients with cancer.1 In these patients, empiric dose reductions are often performed, usually by capping body surface area (BSA) at 2 m2 because of concerns regarding toxicity. However, there is no evidence that administering a full dose of chemotherapy in obese patients with solid cancer is associated with an increased toxicity.1 In addition, the ASCO guidelines highlight the negative impact on prognosis of reduced doses of chemotherapy in obese patients with solid tumors and thus recommend the use of full weight–based doses of cytotoxic chemotherapy, particularly in curable cancers.1 However, the impact of chemotherapy dosing has not been evaluated in non-Hodgkin lymphoma (NHL) patients with elevated BSA.In this study, we aimed to evaluate the impact of doxorubicin dose capping in patients with diffuse large B-cell lymphoma (DLBCL). DLBCL is a curable disease in which relative dose intensity has been described to be associated with treatment efficacy.2 However, clinicians may be concerned with the toxicity of high doses of anthracyclines in patients with elevated BSA.