title: Feasibility and safety of a reduced duration of therapy of colony-stimulating factor in a dose-dense regimen.
abstract: OBJECTIVE
  The risk of febrile neutropenia (FN) in cancer patients receiving chemotherapy is mainly due to the type of chemotherapy regimen and the presence of specific risk factors in patients. The recent trend of using a dose-dense treatment schedule has enhanced the risk of FN. In the present prospective study, we evaluated the feasibility of a reduction of duration of therapy with colony-stimulating factor (G-CSF) in a dose-dense regimen.
  
  
  METHODS
  Between June 2002 and December 2011, 107 patients with a new diagnosis of non-Hodgkin lymphoma (NHL) receiving dose-dense chemotherapy, every 14 days, were included in the study. The primary endpoint was defined as the completion of planned chemotherapy cycles as scheduled. Secondary endpoints were median number of administered G-CSF doses (vials), incidence of FN, hospitalization and toxicity.
  
  
  RESULTS
  The planned chemotherapy cycles (primary endpoint) were completed by 84.1 % of patients. The median number of G-CSF (lenograstim) doses administered for each patient was 24 (range 10-35), which corresponds to a median of five vials (range 0-10) for each cycle. Grades 3-4 toxicities, related to G-CSF administration, included neutropenia and thrombocytopenia (14.0 and 1.9 %, respectively). No grades 3-4 bone pain was detected. The incidence of FN and hospitalization was 9.3 % (10/107) and 4.5 % (5/107), respectively.
  
  
  CONCLUSIONS
  Reduced dosage of G-CSF allows dose-dense chemotherapy scheduling, limits exposure to G-CSF and also represents an opportunity for cost savings.
authors.affiliation: Haematology Department, Azienda Ospedaliero Universitaria Careggi, Largo Brambilla, 3, 50139, Florence, Italy, luigi.rigacci@unifi.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Rigacci
authors.forename: Benedetta
authors.initials: B
authors.lastname: Puccini
authors.forename: Sofia
authors.initials: S
authors.lastname: Kovalchuk
authors.forename: Elisa
authors.initials: E
authors.lastname: Fabbri
authors.forename: Erminio
authors.initials: E
authors.lastname: Bonizzoni
authors.forename: Tania
authors.initials: T
authors.lastname: Perrone
authors.forename: Alberto
authors.initials: A
authors.lastname: Bosi
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage / Q000009:adverse effects; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D000078224:Lenograstim; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D012307:Risk Factors; D000069283:Rituximab; D013921:Thrombocytopenia / Q000139:chemically induced / Q000453:epidemiology; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000069283:Rituximab; D014750:Vincristine; D000078224:Lenograstim; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
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