Therapeutic administration of pegfilgrastim instead of prophylactic use.
OBJECTIVE
Pegfilgrastim is a new growth factor which can be administered subcutaneously once (versus multiple doses for days) on the day neutropenia occurs after chemotherapy. Our aims were to determine: (a) the percentage of patients who needed growth factor (pegfilgrastim) supportive treatment, (b) the duration of neutropenia-leukopenia after pegfilgrastim administration, and (c) the safety in using pegfilgrastim as a treatment and not as a prophylactic agent.


METHODS
Ninety-eight patients were evaluated. All patients were scheduled to undergo chemotherapy treatment, which was either first- or second-line, and some patients had previously received granulocyte colony-stimulating growth factor (G-CSF): filgrastim on a daily basis. Twenty-five/98 patients required G-CSF support and were treated with pegfilgrastim 6 mg; the first 12 patients were admitted to hospital and remained until recovery from grade 3-4 neutropenia; the other 13 patients were treated on an outpatient basis or at home. Pegfilgrastim was administered when neutropenia appeared (days 6-8 following chemotherapy treatment).


RESULTS
Therapeutic administration of pegfilgrastim on the day serious neutropenia occurred was needed by 25/98 patients (25.51%). White blood cell recovery for both grade 3-4 neutropenia was observed within 1-3 days in 75% of the patients treated with pegfilgrastim and in the remaining 25%, within 5 days.


CONCLUSIONS
Pegfilgrastim, an active hemopoietic growth factor with effective slow-absorption properties, can be used safely, not necessarily as a prophylactic agent but on an outpatient basis as a therapy for serious neutropenia.
Stathopoulos
George P
GP
First Oncology Department, Errikos Dunant Hospital, Athens, Greece. dr-gps@ath.forthnet.gr
Dimou
Evangelini
E
Stathopoulos
John
J
Xynotroulas
John
J
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000097:blood / Q000188:drug therapy; D009503:Neutropenia / Q000139:chemically induced / Q000188:drug therapy* / Q000517:prevention & control; D011092:Polyethylene Glycols; D011994:Recombinant Proteins
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000069585:Filgrastim