Equivalence of pegfilgrastim and filgrastim in lymphoma patients treated with BEAM followed by autologous stem cell transplantation

Oncology. 2010;79(1-2):93-7. doi: 10.1159/000320604. Epub 2010 Nov 15.

Abstract

Objective: To evaluate the impact of pegfilgrastim on engraftment, hospital stay and resources in patients with Hodgkin's and non-Hodgkin's lymphoma after conditioning with high-dose BEAM followed by autologous peripheral blood stem cell transplantation (APBSCT) compared with filgrastim.

Methods: We reviewed patient charts and our prospective transplantation database for clinical data from the post-transplant period. An integrated cost analysis, including the use of blood products and length of hospital stay, was also performed.

Results: Fourteen (26%) patients with Hodgkin's lymphoma and 40 (74%) patients with non-Hodgkin's lymphoma were analyzed. Thirty-four (68%) patients received single-dose pegfilgrastim (6 mg), and 20 (32%) patients received daily filgrastim (5 μg/kg) after APBSCT. No differences were observed regarding duration of neutropenia grade 4 (pegfilgrastim median 7 days/filgrastim median 8 days; p = 0.13), thrombocytopenia grade 4 (7/9.5 days, respectively; p = 0.21), fever (4.5/2 days; p = 0.057), intravenous antibiotic treatment (11/10 days; p = 0.75) or length of hospital stay (16.5/16 days; p = 0.27) between the groups. The use of pegfilgrastim resulted in 12% higher treatment-related costs when compared to filgrastim, without reaching statistical significance (p = 0.38).

Conclusion: Pegfilgrastim appears to be equivalent to filgrastim after high-dose BEAM followed by APBSCT in the treatment of lymphoma patients.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Carmustine / administration & dosage
  • Carmustine / adverse effects
  • Cytarabine / administration & dosage
  • Cytarabine / adverse effects
  • Drug Administration Schedule
  • Female
  • Filgrastim
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Hodgkin Disease / drug therapy*
  • Hodgkin Disease / surgery
  • Humans
  • Length of Stay
  • Lymphoma, Non-Hodgkin / drug therapy*
  • Lymphoma, Non-Hodgkin / surgery
  • Male
  • Melphalan / administration & dosage
  • Melphalan / adverse effects
  • Middle Aged
  • Neutropenia / chemically induced
  • Neutropenia / drug therapy*
  • Neutropenia / prevention & control
  • Peripheral Blood Stem Cell Transplantation*
  • Podophyllotoxin / administration & dosage
  • Podophyllotoxin / adverse effects
  • Polyethylene Glycols
  • Recombinant Proteins
  • Severity of Illness Index
  • Thrombocytopenia / chemically induced
  • Thrombocytopenia / drug therapy*
  • Thrombocytopenia / prevention & control
  • Time Factors
  • Transplantation, Autologous
  • Treatment Outcome
  • Young Adult

Substances

  • Recombinant Proteins
  • Cytarabine
  • Granulocyte Colony-Stimulating Factor
  • pegfilgrastim
  • Polyethylene Glycols
  • Podophyllotoxin
  • Filgrastim
  • Melphalan
  • Carmustine

Supplementary concepts

  • BEAM protocol