title: Results of a prospective dose intensity and neutropenia prophylaxis evaluation programme (DIEPP) in cancer patients at risk of febrile neutropenia due to myelosuppressive chemotherapy.
abstract: OBJECTIVE
  To describe the incidence of febrile neutropenia (FN) and use of pegfilgrastim in cancer patients with high overall risk of FN and to investigate the relationship between granulocyte-colony stimulating factor (G-CSF) guideline adherence and chemotherapy delivery in Central and Eastern Europe (CEE) and Austria.
  
  
  METHODS
  Dose Intensity Evaluation Program and Prophylaxis (DIEPP) was a multicentre, prospective, and observational study of adult patients with breast cancer, lymphoma, lung cancer, gastric cancer, and ovarian cancer, who received chemotherapy with pegfilgrastim support and who had an overall risk of FN ≥ 20 %. Physicians assessed patient risk factors and reported their reasons for administering pegfilgrastim.
  
  
  RESULTS
  Patients were enrolled from 113 centres in CEE and Austria between August 2010 and July 2013, and data were analysed from 1072 patients. The most common tumour types were breast cancer (50 %) and lymphoma (24 %). FN incidence was 5 % overall. FN occurred in 3 % of patients (28/875) who received pegfilgrastim as primary prophylaxis (PP) and 13 % of patients (19/142) who received it as secondary prophylaxis (SP); 79 % of FN events in SP patients occurred in the first cycle before pegfilgrastim was administered. The three most frequently chosen reasons for using pegfilgrastim were planned chemotherapy with high FN risk, female gender, and advanced disease. Overall, 40 % of patients received > 90 % of their planned chemotherapy dose within 3 days of the planned schedule.
  
  
  CONCLUSIONS
  FN incidence was relatively low with pegfilgrastim PP in patients with a physician-assessed overall FN risk of ≥ 20 %. The most important reasons for pegfilgrastim use were consistent with the investigators' risk assessment and international guidelines.
authors.affiliation: Clinic of Oncology, Poznan University of Medical Sciences, Szamarzewskiego 82/84, 60-569, Poznan, Poland. r.madry.mac@gmail.com.
authors.forename: Radosław
authors.initials: R
authors.lastname: Mądry
authors.affiliation: The Maria Sklodowska-Curie Memorial Cancer Center, Warsaw, Poland.
authors.forename: Lidia
authors.initials: L
authors.lastname: Popławska
authors.affiliation: Landeskrankenhaus Vöcklabruck, Vöcklabruck, Austria.
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Haslbauer
authors.affiliation: Na Homolce Hospital, Prague, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Šafanda
authors.affiliation: Ploiesti Municipal Hospital, Ploiesti, Romania.
authors.forename: Doru
authors.initials: D
authors.lastname: Ghizdavescu
authors.affiliation: Oncology clinic, St. Vincent s.r.o, Prievidza, Slovak Republic.
authors.forename: Jana
authors.initials: J
authors.lastname: Benkovicova
authors.affiliation: Jász-Nagykun-Szolnok County Hospital, Szolnok, Hungary.
authors.forename: Tibor
authors.initials: T
authors.lastname: Csőszi
authors.affiliation: Specialized Hospital for Active Treatment of Haematological Diseases, Sofia, Bulgaria.
authors.forename: Georgi
authors.initials: G
authors.lastname: Mihaylov
authors.affiliation: Amgen GmbH, Head Office for Central & Eastern Europe, Vienna, Austria.
authors.forename: Daniela
authors.initials: D
authors.lastname: Niepel
authors.affiliation: Amgen Austria GmbH, Vienna, Austria.
authors.forename: Christine
authors.initials: C
authors.lastname: Jaeger
authors.affiliation: Amgen Slovakia s.r.o, Piestany, Slovak Republic.
authors.forename: Iveta
authors.initials: I
authors.lastname: Frkanova
authors.affiliation: Amgen Romania Srl, Bucharest, Romania.
authors.forename: Alina
authors.initials: A
authors.lastname: Macovei
authors.affiliation: Medical University of Vienna, Vienna, Austria.
authors.forename: Christine
authors.initials: C
authors.lastname: Staudigl
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001317:Austria / Q000453:epidemiology; D064146:Chemotherapy-Induced Febrile Neutropenia / Q000453:epidemiology / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D005061:Europe, Eastern / Q000453:epidemiology; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000592:standards; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000453:epidemiology*; D009503:Neutropenia / Q000453:epidemiology / Q000517:prevention & control*; D011092:Polyethylene Glycols; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000592:standards; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; C455861:pegfilgrastim; D011092:Polyethylene Glycols; D000069585:Filgrastim
keywords: Chemotherapy; Febrile neutropenia; Granulocyte colony-stimulating factor; Neoplasms; Observational study