Pegfilgrastim appears equivalent to daily dosing of filgrastim to treat neutropenia after autologous peripheral blood stem cell transplantation in patients with non-hodgkin lymphoma

Robert Rifkin, Gary Spitzer, Gregory Orloff, Romeo Mandanas, Dean McGaughey, Feng Zhan, Kristi A. Boehm, Lina Asmar, Roy Beveridge

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)186-191
Number of pages6
JournalClinical Lymphoma, Myeloma and Leukemia
Volume10
Issue number3
DOIs
StatePublished - Jan 1 2010
Externally publishedYes

Fingerprint

Peripheral Blood Stem Cell Transplantation
Neutropenia
Non-Hodgkin's Lymphoma
Carmustine
Erythrocyte Transfusion
Neutrophils
Cytarabine
Etoposide
Drug Therapy
Transplantation
Febrile Neutropenia
Platelet Transfusion
Melphalan
Cryopreservation
Cyclophosphamide
pegfilgrastim
Filgrastim
Blood Cells
Histology
Stem Cells

Keywords

  • Growth factor
  • Multicenter
  • Posttransplantation
  • Supportive care

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

Pegfilgrastim appears equivalent to daily dosing of filgrastim to treat neutropenia after autologous peripheral blood stem cell transplantation in patients with non-hodgkin lymphoma. / Rifkin, Robert; Spitzer, Gary; Orloff, Gregory; Mandanas, Romeo; McGaughey, Dean; Zhan, Feng; Boehm, Kristi A.; Asmar, Lina; Beveridge, Roy.

In: Clinical Lymphoma, Myeloma and Leukemia, Vol. 10, No. 3, 01.01.2010, p. 186-191.

Research output: Contribution to journalArticle

Rifkin, Robert ; Spitzer, Gary ; Orloff, Gregory ; Mandanas, Romeo ; McGaughey, Dean ; Zhan, Feng ; Boehm, Kristi A. ; Asmar, Lina ; Beveridge, Roy. / Pegfilgrastim appears equivalent to daily dosing of filgrastim to treat neutropenia after autologous peripheral blood stem cell transplantation in patients with non-hodgkin lymphoma. In: Clinical Lymphoma, Myeloma and Leukemia. 2010 ; Vol. 10, No. 3. pp. 186-191.
@article{8a385282a34342fd85f842130bec873b,
title = "Pegfilgrastim appears equivalent to daily dosing of filgrastim to treat neutropenia after autologous peripheral blood stem cell transplantation in patients with non-hodgkin lymphoma",
abstract = "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.",
keywords = "Growth factor, Multicenter, Posttransplantation, Supportive care",
author = "Robert Rifkin and Gary Spitzer and Gregory Orloff and Romeo Mandanas and Dean McGaughey and Feng Zhan and Boehm, {Kristi A.} and Lina Asmar and Roy Beveridge",
year = "2010",
month = "1",
day = "1",
doi = "10.3816/CLML.2010.n.029",
language = "English (US)",
volume = "10",
pages = "186--191",
journal = "Clinical Lymphoma, Myeloma and Leukemia",
issn = "2152-2669",
publisher = "Cancer Media Group",
number = "3",

}

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

PY - 2010/1/1

Y1 - 2010/1/1

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

VL - 10

SP - 186

EP - 191

JO - Clinical Lymphoma, Myeloma and Leukemia

JF - Clinical Lymphoma, Myeloma and Leukemia

SN - 2152-2669

IS - 3

ER -