title: Pegfilgrastim after high-dose chemotherapy and autologous peripheral blood stem cell transplant: phase II study.
abstract: Pegfilgrastim is equivalent to daily filgrastim after standard dose chemotherapy in decreasing the duration of neutropenia. Daily filgrastim started within 1-4 days after autologous stem cell transplant (ASCT) leads to significant decrease in time to neutrophil engraftment. We undertook a study of pegfilgrastim after high-dose chemotherapy (HDC) and ASCT. In all, 38 patients with multiple myeloma or lymphoma, eligible to undergo HDC and ASCT, were enrolled. Patients received a single dose of 6 mg pegfilgrastim subcutaneously 24 h after ASCT. There were no adverse events secondary to pegfilgrastim. All patients engrafted neutrophils and platelets with a median of 10 and 18 days, respectively. The incidence of febrile neutropenia was 49% (18/37). Neutrophil engraftment results were compared to a historical cohort of patients who received no growth factors or prophylactic filgrastim after ASCT. Time to neutrophil engraftment using pegfilgrastim was comparable to daily filgrastim and was shorter than in a historical group receiving no filgrastim (10 vs 13.7 days, P<0.001). Pegfilgrastim given as a single fixed dose of 6 mg appears to be safe after HDC and ASCT. It accelerates neutrophil engraftment comparable to daily filgrastim after ASCT. Pegfilgrastim may be convenient to use in outpatient transplant units.
authors.affiliation: Division of Hematology-Oncology, Vanderbilt Ingram Cancer Center, Nashville, TN 37232-5505, USA. madan.jagsia@vanderbilt.edu
authors.forename: M H
authors.initials: MH
authors.lastname: Jagasia
authors.forename: J P
authors.initials: JP
authors.lastname: Greer
authors.forename: D S
authors.initials: DS
authors.lastname: Morgan
authors.forename: S
authors.initials: S
authors.lastname: Mineishi
authors.forename: A A
authors.initials: AA
authors.lastname: Kassim
authors.forename: K L
authors.initials: KL
authors.lastname: Ruffner
authors.forename: H
authors.initials: H
authors.lastname: Chen
authors.forename: F G
authors.initials: FG
authors.lastname: Schuening
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D005260:Female; D000069585:Filgrastim; D006085:Graft Survival; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D038042:Myelopoiesis / Q000187:drug effects; D009503:Neutropenia / Q000188:drug therapy / Q000517:prevention & control*; D009504:Neutrophils / Q000502:physiology; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D014182:Transplantation, Autologous
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000069585:Filgrastim