Filgrastim versus TBO-filgrastim to reduce the duration of neutropenia after autologous hematopoietic stem cell transplantation: TBO, or not TBO, that is the question.
After a hospital-wide formulary change resulted in the replacement of filgrastim with TBO-filgrastim for all on- and off-label indications, we performed a retrospective comparison of patients with myeloma receiving 200 mg/m(2) melphalan with autologous hematopoietic stem cell transplantation to see whether the type of growth factor used post-transplant made a difference. One hundred and eighty-two consecutive patients with myeloma were studied, 91 receiving filgrastim immediately prior to the change and 91 receiving TBO-filgrastim afterward. The CD34(+) cell dose was comparable, as were other characteristics. Although the overall time to neutrophil recovery was similar for both groups, early engraftment (≤ 12 d) occurred more often (p = 0.05), and late engraftment (≥ 14 d) less often (p = 0.09) in filgrastim-treated patients. The number of documented infections was significantly less in the TBO-filgrastim group. Day 100 mortality and hospital stay were similar for the two groups. These data indicate that there is no material difference between filgrastim and TBO-filgrastim in this clinical setting.
Department of Medicine and Pharmacy, Northwestern University, Chicago, IL, USA.
Steven
S
Trifilio
Department of Medicine, Northwestern University, Chicago, IL, USA.
Zheng
Z
Zhou
Department of Medicine, Northwestern University, Chicago, IL, USA.
John
J
Galvin
Department of Pharmacy, Northwestern Hospital, Chicago, IL, USA.
Jessica L
JL
Fong
Department of Medicine, Northwestern University, Chicago, IL, USA.
Joanne
J
Monreal
Department of Medicine, Northwestern University, Chicago, IL, USA.
Jayesh
J
Mehta
D000328:Adult; D000368:Aged; D005260:Female; D000069585:Filgrastim / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006085:Graft Survival; D006401:Hematologic Agents / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000628:therapy; D009503:Neutropenia / Q000188:drug therapy* / Q000209:etiology; D011379:Prognosis; D012307:Risk Factors; D013997:Time Factors; D014182:Transplantation, Autologous
D006401:Hematologic Agents; D000069585:Filgrastim
Filgrastim; TBO-filgrastim; engraftment; infection; length of hospital admission