TY - JOUR
T1 - Pegfilgrastim appears equivalent to daily dosing of filgrastim to treat neutropenia after autologous peripheral blood stem cell transplantation in patients with non-hodgkin lymphoma
AU - Rifkin, Robert
AU - Spitzer, Gary
AU - Orloff, Gregory
AU - Mandanas, Romeo
AU - McGaughey, Dean
AU - Zhan, Feng
AU - Boehm, Kristi A.
AU - Asmar, Lina
AU - Beveridge, Roy
N1 - Funding Information:
We thank the patients who shared their experiences with US Oncology physicians (see Appendix); the site coordinators in the field, Kim K. Seeley, RN (Greenville, SC), project managers Sharon Ambro, RN, and Mary Ann Rauch, MPh; program manager Julie Boston, RN; and data reviewers Cindy Brissman, LVN, and Tracy Locke, RHIA, who ensured the integrity of the data. Research support was provided by Amgen, Inc, Thousand Oaks, CA
PY - 2010/6
Y1 - 2010/6
N2 - Background: Filgrastim decreases the time to neutrophil recovery after autologous peripheral blood stem cell transplantation (PBSCT). We hypothesized that single-dose pegfilgrastim would mimic multiple daily doses of filgrastim, resulting in an equivalent shortening of post-PBSCT neutropenia. Patients and Methods: Patients who were eligible for PBSCT and aged ≥ 18 years were identified before high-dose chemotherapy, after the harvesting and cryopreservation of peripheral blood progenitor cells (ie, > 2.5 × 106 CD34-positive cells/kg). Eligible patients received either standard carmustine/etoposide/cytarabine/melphalan (BEAM) or carmustine/etoposide/cytarabine/cyclophosphamide (BEAC) high-dose chemotherapy. Before high-dose chemotherapy, patients were randomly assigned to receive pegfilgrastim 6 mg on day 1 (arm A) or weight-based, dose-adjusted filgrastim beginning on day 1 (arm B) after transplantation until neutrophil engraftment. Results: One-hundred and one patients were enrolled between April 2003 and April 2007. Three patients were not treated. Demographics were well-balanced in terms of stage at diagnosis, Eastern Cooperative Oncology Group performance status, histology, and lines of previous therapy. Results (arm A/arm B) pertained to mean doses received (1.0/12.6), mean absolute neutrophil count recovery days (9.3/9.8), red blood cell transfusions (1.7/1.9), red blood cell transfusion units (3.1/3.8), platelet transfusions (3.1/2.8), positive blood culture rate (18%/29.2%), febrile neutropenia (FN; 18%/16.7%), and duration of FN (days; 7.1/6.9). Transplantation-related mortality and grade 3 or 4 adverse events were comparable between arms. Conclusion: Pegfilgrastim after PBSCT appears equivalent to multiple daily doses of filgrastim. This approach might be considered in lieu of filgrastim, thus obviating the need for multiple daily injections.
AB - Background: Filgrastim decreases the time to neutrophil recovery after autologous peripheral blood stem cell transplantation (PBSCT). We hypothesized that single-dose pegfilgrastim would mimic multiple daily doses of filgrastim, resulting in an equivalent shortening of post-PBSCT neutropenia. Patients and Methods: Patients who were eligible for PBSCT and aged ≥ 18 years were identified before high-dose chemotherapy, after the harvesting and cryopreservation of peripheral blood progenitor cells (ie, > 2.5 × 106 CD34-positive cells/kg). Eligible patients received either standard carmustine/etoposide/cytarabine/melphalan (BEAM) or carmustine/etoposide/cytarabine/cyclophosphamide (BEAC) high-dose chemotherapy. Before high-dose chemotherapy, patients were randomly assigned to receive pegfilgrastim 6 mg on day 1 (arm A) or weight-based, dose-adjusted filgrastim beginning on day 1 (arm B) after transplantation until neutrophil engraftment. Results: One-hundred and one patients were enrolled between April 2003 and April 2007. Three patients were not treated. Demographics were well-balanced in terms of stage at diagnosis, Eastern Cooperative Oncology Group performance status, histology, and lines of previous therapy. Results (arm A/arm B) pertained to mean doses received (1.0/12.6), mean absolute neutrophil count recovery days (9.3/9.8), red blood cell transfusions (1.7/1.9), red blood cell transfusion units (3.1/3.8), platelet transfusions (3.1/2.8), positive blood culture rate (18%/29.2%), febrile neutropenia (FN; 18%/16.7%), and duration of FN (days; 7.1/6.9). Transplantation-related mortality and grade 3 or 4 adverse events were comparable between arms. Conclusion: Pegfilgrastim after PBSCT appears equivalent to multiple daily doses of filgrastim. This approach might be considered in lieu of filgrastim, thus obviating the need for multiple daily injections.
KW - Growth factor
KW - Multicenter
KW - Posttransplantation
KW - Supportive care
UR - http://www.scopus.com/inward/record.url?scp=77955888016&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77955888016&partnerID=8YFLogxK
U2 - 10.3816/CLML.2010.n.029
DO - 10.3816/CLML.2010.n.029
M3 - Article
C2 - 20511163
AN - SCOPUS:77955888016
SN - 2152-2650
VL - 10
SP - 186
EP - 191
JO - Clinical Lymphoma, Myeloma and Leukemia
JF - Clinical Lymphoma, Myeloma and Leukemia
IS - 3
ER -