G-CSF (filgrastim) as an adjunct to MOPP/ABVD therapy in Hodgkin's disease.
The main objective of this study was to assess to what extent filgrastim (G-CSF, Amgen-Roche) can facilitate administration of the full dose intensity of MOPP/ABVD chemotherapy to patients with Hodgkin's disease. Sixteen patients with Hodgkin's disease were treated with MOPP/ABVD and filgrastim support between January 1992 and March 1994. Twenty-five patients treated with MOPP/ABVD 1987-1991 served as historical controls. The two groups were well matched for age, gender, stage, performance status and histological subgroups, but in the study group more patients had B-symptoms (p < 0.05). Dose intensity (DI) was calculated in mg/m2/week and the intended average dose was designated as 1. The planned average DI was reached by 8/16 patients in the study group but by only 1/25 in the control group (p < 0.001). The reasons for decreased DI in the study group were neutropenia (n = 5), thrombocytopenia (2 pts) and neurotoxicity (n = 1). In the control group the reason for decreased DI was neutropenia (n = 24). In the study group 15/16 patients achieved Complete Response (CR), 2/15 relapsed and 15/16 were surviving after a median follow-up 31 (6-48) months. In the control group 25/25 patients attained CR, 5/25 relapsed and 20/25 were surviving after a median follow up 67 (12-100) months. No severe toxicity was observed during filgrastim therapy. To conclude, the dose intensity during MOPP/ABVD therapy was significantly higher if filgrastim was administered, but the additional benefit that this confers remains to be determined. A large scale, retrospective analyses of treatment response and actual dose-intensity should help answer this question and give guidance as to if and when hematopoietic growth factors should be administered to patients with Hodgkin's disease.
Gustavsson
A
A
Department of Oncology, University Hospital, Lund, Sweden.
D000328:Adult; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D016022:Case-Control Studies; D003606:Dacarbazine / Q000008:administration & dosage; D018572:Disease-Free Survival; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D000069585:Filgrastim; D005500:Follow-Up Studies; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D006397:Hematinics / Q000008:administration & dosage / Q000627:therapeutic use*; D006689:Hodgkin Disease / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008466:Mechlorethamine / Q000008:administration & dosage; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D009420:Nervous System / Q000187:drug effects; D009503:Neutropenia / Q000139:chemically induced / Q000517:prevention & control; D011241:Prednisone / Q000008:administration & dosage; D011344:Procarbazine / Q000008:administration & dosage; D011994:Recombinant Proteins; D012074:Remission Induction; D012189:Retrospective Studies; D015996:Survival Rate; D013921:Thrombocytopenia / Q000139:chemically induced / Q000517:prevention & control; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage; D014750:Vincristine / Q000008:administration & dosage
D000903:Antibiotics, Antineoplastic; D000970:Antineoplastic Agents; D018906:Antineoplastic Agents, Alkylating; D018931:Antineoplastic Agents, Hormonal; D000972:Antineoplastic Agents, Phytogenic; D006397:Hematinics; D011994:Recombinant Proteins; D001761:Bleomycin; D016179:Granulocyte Colony-Stimulating Factor; D011344:Procarbazine; D008466:Mechlorethamine; D014750:Vincristine; D014747:Vinblastine; D003606:Dacarbazine; D004317:Doxorubicin; D000069585:Filgrastim; D011241:Prednisone