PEGFILGRASTIM IN PRIMARY PROPHYLAXIS OF FEBRILE NEUTROPENIA DURING RITUXIMAB-BENDAMUSTINE TREATMENT IN INDOLENT NON HODGKIN LYMPHOMA : A REAL-LIFE EXPERIENCE
(Abstract release date: 05/19/16)
EHA Library. Cerchione C. 06/09/16; 134766; PB1866
Dr. Claudio Cerchione
Contributions
Contributions
Abstract
Abstract: PB1866
Type: Publication Only
Background
Febrile neutropenia (FN) is a serious side effect of chemotherapy, and even when it does not result in significant morbidity, mortality and costs, it normally leads to a delay in chemotherapy treatments.
Aims
Pegfilgrastim is a pegylated long-acting recombinant form of G-CSF which extends the half-life, requiring less frequent dosing. The objective was to evaluate the efficacy and safety of pegfilgrastim in newly diagnosed patients with indolent NHL, in treatment with R-Bendamustine (RB), in order to determine whether a single injection of pegfilgrastim is as effective as daily injections of filgrastim, in terms of toxicity, febrile neutropenic episodes, antibiotic usage, and hospitalization duration.
Methods
59 patients (31 M/28 F), median age 48.7 years (range 33-87), since first course of treatment performed blood counts twice weekly and received, d8-d19, prophylactic oral quinolones and anti-fungal drugs. During neutropenia, filgrastim (5 µg/kg/d for at least 3 days) was given “on demand” if neutrophils count was < 1000 x 10^9 cells/L. Median number of filgrastim administrations was 3.4 (r.3-5); nadir neutropenia was registered after a median of 9.1 d. (r.8-15); median of nadir neutrophil count was 1.27 x 10^9 cells/L (range 0.3-1.7 x 10^9 cells/L), with maximum duration of 11 days. From the second course, all patients switched to pegfilgrastim (6 mg) prophylaxis, injected subcutaneously with a single administration on day + 4.
Results
During pegfilgrastim, neutropenia was never longer than 7 days, with a consequent reduction of risk of infections. Median nadir neutrophil count, evaluated for at least 3 courses of therapy (r.3-6) registered at d+ 11, was 1.626 (range 0.88-2.11 x 10^9 cells/L); only 9 patients (15.2%) needed, after pegfilgrastim, a supplement of 3 administrations of filgrastim. During pegfilgrastim, neutropenia, when present, was shorter than during filgrastim treatment (median of 3.3 d, range 3-8). Pegfilgrastim was well tolerated: main side effects were mild fever and bone pain (8/59 : 13.5%). Moreover, no hospitalization was needed during pegfilgrastim, while two hospitalization for pneumonia were needed during filgrastim. During observation, no patient died during filgrastim or pegfilgrastim.
Conclusion
In patients affected by newly diagnosed patients indolent NHL, in treatment with RB, pegfilgrastim seems to reduce the incidence of neutropenia, is better tolerated and may increase the possibility to maintain the schedule of treatment.
Session topic: E-poster
Type: Publication Only
Background
Febrile neutropenia (FN) is a serious side effect of chemotherapy, and even when it does not result in significant morbidity, mortality and costs, it normally leads to a delay in chemotherapy treatments.
Aims
Pegfilgrastim is a pegylated long-acting recombinant form of G-CSF which extends the half-life, requiring less frequent dosing. The objective was to evaluate the efficacy and safety of pegfilgrastim in newly diagnosed patients with indolent NHL, in treatment with R-Bendamustine (RB), in order to determine whether a single injection of pegfilgrastim is as effective as daily injections of filgrastim, in terms of toxicity, febrile neutropenic episodes, antibiotic usage, and hospitalization duration.
Methods
59 patients (31 M/28 F), median age 48.7 years (range 33-87), since first course of treatment performed blood counts twice weekly and received, d8-d19, prophylactic oral quinolones and anti-fungal drugs. During neutropenia, filgrastim (5 µg/kg/d for at least 3 days) was given “on demand” if neutrophils count was < 1000 x 10^9 cells/L. Median number of filgrastim administrations was 3.4 (r.3-5); nadir neutropenia was registered after a median of 9.1 d. (r.8-15); median of nadir neutrophil count was 1.27 x 10^9 cells/L (range 0.3-1.7 x 10^9 cells/L), with maximum duration of 11 days. From the second course, all patients switched to pegfilgrastim (6 mg) prophylaxis, injected subcutaneously with a single administration on day + 4.
Results
During pegfilgrastim, neutropenia was never longer than 7 days, with a consequent reduction of risk of infections. Median nadir neutrophil count, evaluated for at least 3 courses of therapy (r.3-6) registered at d+ 11, was 1.626 (range 0.88-2.11 x 10^9 cells/L); only 9 patients (15.2%) needed, after pegfilgrastim, a supplement of 3 administrations of filgrastim. During pegfilgrastim, neutropenia, when present, was shorter than during filgrastim treatment (median of 3.3 d, range 3-8). Pegfilgrastim was well tolerated: main side effects were mild fever and bone pain (8/59 : 13.5%). Moreover, no hospitalization was needed during pegfilgrastim, while two hospitalization for pneumonia were needed during filgrastim. During observation, no patient died during filgrastim or pegfilgrastim.
Conclusion
In patients affected by newly diagnosed patients indolent NHL, in treatment with RB, pegfilgrastim seems to reduce the incidence of neutropenia, is better tolerated and may increase the possibility to maintain the schedule of treatment.
Session topic: E-poster
Abstract: PB1866
Type: Publication Only
Background
Febrile neutropenia (FN) is a serious side effect of chemotherapy, and even when it does not result in significant morbidity, mortality and costs, it normally leads to a delay in chemotherapy treatments.
Aims
Pegfilgrastim is a pegylated long-acting recombinant form of G-CSF which extends the half-life, requiring less frequent dosing. The objective was to evaluate the efficacy and safety of pegfilgrastim in newly diagnosed patients with indolent NHL, in treatment with R-Bendamustine (RB), in order to determine whether a single injection of pegfilgrastim is as effective as daily injections of filgrastim, in terms of toxicity, febrile neutropenic episodes, antibiotic usage, and hospitalization duration.
Methods
59 patients (31 M/28 F), median age 48.7 years (range 33-87), since first course of treatment performed blood counts twice weekly and received, d8-d19, prophylactic oral quinolones and anti-fungal drugs. During neutropenia, filgrastim (5 µg/kg/d for at least 3 days) was given “on demand” if neutrophils count was < 1000 x 10^9 cells/L. Median number of filgrastim administrations was 3.4 (r.3-5); nadir neutropenia was registered after a median of 9.1 d. (r.8-15); median of nadir neutrophil count was 1.27 x 10^9 cells/L (range 0.3-1.7 x 10^9 cells/L), with maximum duration of 11 days. From the second course, all patients switched to pegfilgrastim (6 mg) prophylaxis, injected subcutaneously with a single administration on day + 4.
Results
During pegfilgrastim, neutropenia was never longer than 7 days, with a consequent reduction of risk of infections. Median nadir neutrophil count, evaluated for at least 3 courses of therapy (r.3-6) registered at d+ 11, was 1.626 (range 0.88-2.11 x 10^9 cells/L); only 9 patients (15.2%) needed, after pegfilgrastim, a supplement of 3 administrations of filgrastim. During pegfilgrastim, neutropenia, when present, was shorter than during filgrastim treatment (median of 3.3 d, range 3-8). Pegfilgrastim was well tolerated: main side effects were mild fever and bone pain (8/59 : 13.5%). Moreover, no hospitalization was needed during pegfilgrastim, while two hospitalization for pneumonia were needed during filgrastim. During observation, no patient died during filgrastim or pegfilgrastim.
Conclusion
In patients affected by newly diagnosed patients indolent NHL, in treatment with RB, pegfilgrastim seems to reduce the incidence of neutropenia, is better tolerated and may increase the possibility to maintain the schedule of treatment.
Session topic: E-poster
Type: Publication Only
Background
Febrile neutropenia (FN) is a serious side effect of chemotherapy, and even when it does not result in significant morbidity, mortality and costs, it normally leads to a delay in chemotherapy treatments.
Aims
Pegfilgrastim is a pegylated long-acting recombinant form of G-CSF which extends the half-life, requiring less frequent dosing. The objective was to evaluate the efficacy and safety of pegfilgrastim in newly diagnosed patients with indolent NHL, in treatment with R-Bendamustine (RB), in order to determine whether a single injection of pegfilgrastim is as effective as daily injections of filgrastim, in terms of toxicity, febrile neutropenic episodes, antibiotic usage, and hospitalization duration.
Methods
59 patients (31 M/28 F), median age 48.7 years (range 33-87), since first course of treatment performed blood counts twice weekly and received, d8-d19, prophylactic oral quinolones and anti-fungal drugs. During neutropenia, filgrastim (5 µg/kg/d for at least 3 days) was given “on demand” if neutrophils count was < 1000 x 10^9 cells/L. Median number of filgrastim administrations was 3.4 (r.3-5); nadir neutropenia was registered after a median of 9.1 d. (r.8-15); median of nadir neutrophil count was 1.27 x 10^9 cells/L (range 0.3-1.7 x 10^9 cells/L), with maximum duration of 11 days. From the second course, all patients switched to pegfilgrastim (6 mg) prophylaxis, injected subcutaneously with a single administration on day + 4.
Results
During pegfilgrastim, neutropenia was never longer than 7 days, with a consequent reduction of risk of infections. Median nadir neutrophil count, evaluated for at least 3 courses of therapy (r.3-6) registered at d+ 11, was 1.626 (range 0.88-2.11 x 10^9 cells/L); only 9 patients (15.2%) needed, after pegfilgrastim, a supplement of 3 administrations of filgrastim. During pegfilgrastim, neutropenia, when present, was shorter than during filgrastim treatment (median of 3.3 d, range 3-8). Pegfilgrastim was well tolerated: main side effects were mild fever and bone pain (8/59 : 13.5%). Moreover, no hospitalization was needed during pegfilgrastim, while two hospitalization for pneumonia were needed during filgrastim. During observation, no patient died during filgrastim or pegfilgrastim.
Conclusion
In patients affected by newly diagnosed patients indolent NHL, in treatment with RB, pegfilgrastim seems to reduce the incidence of neutropenia, is better tolerated and may increase the possibility to maintain the schedule of treatment.
Session topic: E-poster
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