Real-World Impact of Prophylactic Pegfilgrastim in Diffuse Large B-Cell Lymphoma (DLBCL) Patients Receiving Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone (CHOP) With or Without Rituximab Chemotherapy in Korea

Conference Correspondent  - Conference Correspondent, ASHP

In this single-center, retrospective cohort study, electronic medical records were used to examine the real-world impact of prophylactic pegfilgrastim (PP) in patients with diffuse large B-cell lymphoma (DLBCL) receiving cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP)-based chemotherapy.

The primary end point of this study was the comparison of febrile neutropenia and neutropenia events at first cycle. The secondary end point was the comparison of febrile neutropenia and neutropenia events across all cycles. Patients were randomized into 2 groups: the PP group and the non-PP group. Baseline characteristics were comparable across treatment groups.

A total of 160 patients were enrolled in this study at the Asan Medical Center in Korea. At cycle 1, the incidence of febrile neutropenia was significantly lower in patients who received PP versus patients who did not (6 PP cases [7.8%] vs 16 non-PP cases [19.3%]; P = 0.035). The rates of grades 3 and 4 neutropenia were significantly lower in the PP group (48.1%) versus patients who did not receive PP (67.5%; P = 0.013). There were statistically significant differences by cycle, but neutropenia incidence of the PP group trended.

Across all treatment cycles, the PP group reported lower incidence of grades 3 and 4 neutropenia but were only statistically significant at cycles 1 (P <0.05), 5 (P <0.01), and 6 (P <0.01). In a multiple logistic regression, hemoglobin <12 g/dL, platelets <100 k/mm3, and serum creatinine ≥1.4 mg/dL were associated with febrile neutropenia occurrence.

In conclusion, PP was associated with fewer neutropenic events in patients receiving CHOP with or without rituximab for DLBCL, regardless of cycles. The data report that it is reasonable to utilize PP during all chemotherapy cycles, especially cycle 1, as there is often a higher incidence of neutropenic events. Consideration should be given to patient-related risk factors when determining the appropriate use of pegfilgrastim.

Lee M. Abstract presented at ASHP Midyear Clinical Meeting. Las Vegas, NV; December 2016. Abstract 196544.

Related Items
Centers for Disease Control and Prevention Guidelines on Opioid Use for Cancer Pain
Chase Doyle
TOP - August 2017, Vol 10, No 3 published on August 1, 2017 in Conference Correspondent, HOPA
Maintenance Chemotherapy After Hematopoietic Stem-Cell Transplantation
Chase Doyle
TOP - August 2017, Vol 10, No 3 published on August 1, 2017 in Conference Correspondent, HOPA
Graft-versus-Host Disease: Breakthroughs on the Horizon
Chase Doyle
TOP - August 2017, Vol 10, No 3 published on August 1, 2017 in Conference Correspondent, HOPA
Basket Clinical Trials: A New Era in Cancer Treatment
Chase Doyle
TOP - August 2017, Vol 10, No 3 published on August 1, 2017 in Conference Correspondent, HOPA
Burnout Rates High for Pharmacists in Hematopoietic Stem-Cell Transplantation
Chase Doyle
TOP - August 2017, Vol 10, No 3 published on August 1, 2017 in Conference Correspondent, HOPA
Chemotherapy Treatment Considerations in Special Patient Populations
Chase Doyle
TOP - August 2017, Vol 10, No 3 published on August 1, 2017 in Conference Correspondent, HOPA
Nivolumab/Ipilimumab Combination Extends Survival for Patients with Melanoma
Phoebe Starr
TOP - August 2017, Vol 10, No 3 published on August 1, 2017 in Melanoma, AACR News, Conference Correspondent
Pursuit of Biomarkers for CDK4/CDK6 Response Fails
Phoebe Starr
TOP - August 2017, Vol 10, No 3 published on August 1, 2017 in AACR News, Conference Correspondent
Abemaciclib Moves Forward in Metastatic Breast Cancer
Phoebe Starr
TOP - August 2017, Vol 10, No 3 published on August 1, 2017 in AACR News, Conference Correspondent
Updated NCCN Guidelines for Neuroendocrine Tumors and Carcinoid Syndrome Features New Therapies
Wayne Kuznar
TOP - August 2017, Vol 10, No 3 published on August 1, 2017 in Conference Correspondent, NCCN
Last modified: February 20, 2019