Pegfilgrastim Prophylaxis Is Effective in the Prevention of Febrile Neutropenia and Reduces Mortality in Patients Aged ≥ 75 Years with Diffuse Large B-Cell Lymphoma Treated with R-CHOP: A Prospective Cohort Studyopen access
- Authors
- Jeong, Seong Hyun; Kim, Seok Jin; Yoon, Dok Hyun; Park, Yong; Kang, Hye Jin; Koh, Youngil; Lee, Gyeong-Won; Lee, Won-Sik; Yang, Deok-Hwan; Do, Young Rok; Kim, Min Kyoung; Yoo, Kwai Han; Choi, Yoon Seok; Yun, Hwan Jung; Yi, Jun Ho; Jo, Jae-Cheol; Eom, Hyeon-Seok; Kwak, Jae-Yong; Shin, Ho-Jin; Park, Byeong Bae; Hyun, Shin Young; Yi, Seong Yoon; Kwon, Ji-Hyun; Oh, Sung Yong; Kim, Hyo Jung; Sohn, Byeong Seok; Won, Jong Ho; Kim, Se-Hyung; Lee, Ho-Sup; Suh, Cheolwon; Kim, Won Seog
- Issue Date
- Oct-2022
- Publisher
- 대한암학회
- Keywords
- Pegfilgrastim; Prophylaxis; Diffuse large B-cell lymphoma
- Citation
- Cancer Research and Treatment, v.54, no.4, pp 1268 - 1277
- Pages
- 10
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- Cancer Research and Treatment
- Volume
- 54
- Number
- 4
- Start Page
- 1268
- End Page
- 1277
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61670
- DOI
- 10.4143/crt.2021.1168
- ISSN
- 1598-2998
2005-9256
- Abstract
- Purpose
Febrile neutropenia (FN) can cause suboptimal treatment and treatment-related mortality (TRM) in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP).
Materials and Methods
We conducted a prospective cohort study to evaluate the effectiveness of pegfilgrastim prophylaxis in DLBCL patients receiving R-CHOP, and we compared them with the PROCESS cohort (n=485).
Results
Since January 2015, 986 patients with DLBCL were enrolled. Pegfilgrastim was administered at least once in 930 patients (94.3%), covering 90.3% of all cycles. FN developed in 137 patients (13.9%) in this cohort (23.7% in the PROCESS cohort, p < 0.001), and 4.2% of all cycles (10.2% in the PROCESS cohort, p < 0.001). Dose delay was less common (≥ 3 days: 18.1% vs. 23.7%, p=0.015; ≥ 5 days: 12.0% vs. 18.3%, p=0.023) in this cohort than in the PROCESS cohort. The incidence of TRM (3.2% vs. 5.6%, p=0.047) and infection-related death (1.8% vs. 4.5%, p=0.004) was lower in this cohort than in the PROCESS cohort. The 4-year overall survival (OS) and progression-free survival (PFS) rates of the two cohorts were not different (OS: 73.0% vs. 71.9%, p=0.545; PFS: 69.5% vs. 68.8%, p=0.616). However, in patients aged ≥ 75 years, the 4-year OS and PFS rates were higher in this cohort than in the PROCESS cohort (OS: 49.6% vs. 33.7%, p=0.032; PFS: 44.2% vs. 30.3% p=0.047).
Conclusion
Pegfilgrastim prophylaxis is effective in the prevention of FN and infection-related death in DLBCL patients receiving R-CHOP, and it also improves OS in patients aged ≥ 75 years.
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Collections - 2. Clinical Science > Department of Medical Oncology and Hematology > 1. Journal Articles
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