title: Pegfilgrastim reduces the length of hospitalization and the time to engraftment in multiple myeloma patients treated with melphalan 200 and auto-SCT compared with filgrastim.
abstract: To reduce the duration of neutropenia after conditioning chemotherapy and autologous peripheral blood stem cell transplantation (APBSCT), granulocyte-colony stimulating factors (G-CSF) are commonly administered. We retrospectively evaluated the impact of pegfilgrastim compared to filgrastim on neutrophil engraftment, hospital stay, and supportive measures in patients with multiple myeloma after conditioning with Melphalan 200 (Mel200) followed by APBSCT. Ninety-two APBSCT after Mel200 treatment were performed in 72 patients between January 2006 and December 2009 at our institution. Patients received either single-dose pegfilgrastim (n = 46; 50%), or daily filgrastim (n = 46; 50%) after APBSCT (median duration of filgrastim use, 9 days; range, 3-14 days). Duration of neutropenia grade IV was shorter with pegfilgrastim compared with filgrastim (median, 5 days (range, 3-14 days) versus 6 days (range, 3-9 days), p = 0.0079). The length of hospitalization differed significantly (pegfilgrastim (median, 14.5 days; range, 11-47 days) versus filgrastim (median, 15.5 days; range, 12-64 days), p = 0.024). Pegfilgrastim-treated patients had less red blood cell transfusions (median, 0 transfusions (range, 0-10) versus 0.5 transfusions (range, 0-9), p = 0.00065). Pegfilgrastim was associated with reduced cost of the treatment procedure compared with filgrastim (p = 0.031). Pegfilgrastim appears to be at least equivalent to filgrastim without additional expenditure in myeloma patients treated with Mel200 and APBSCT.
authors: Department of Oncology, University Hospital Zürich, Rämistrasse 100, 8091, Zürich, Switzerland.
authors: Panagiotis
authors: P
authors: Samaras
authors: Marcel
authors: M
authors: Blickenstorfer
authors: Raffaele Daniele
authors: RD
authors: Siciliano
authors: Sarah R
authors: SR
authors: Haile
authors: Elefteri M
authors: EM
authors: Buset
authors: Ulf
authors: U
authors: Petrausch
authors: Axel
authors: A
authors: Mischo
authors: Hanspeter
authors: H
authors: Honegger
authors: Urs
authors: U
authors: Schanz
authors: Georg
authors: G
authors: Stussi
authors: Rolf A
authors: RA
authors: Stahel
authors: Alexander
authors: A
authors: Knuth
authors: Frank
authors: F
authors: Stenner-Liewen
authors: Christoph
authors: C
authors: Renner
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004304:Dosage Forms; D004305:Dose-Response Relationship, Drug; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008558:Melphalan / Q000008:administration & dosage*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods; D011092:Polyethylene Glycols; D011994:Recombinant Proteins; D013997:Time Factors; D019172:Transplantation Conditioning / Q000379:methods / Q000706:statistics & numerical data; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D004304:Dosage Forms; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000069585:Filgrastim; D008558:Melphalan