Korean J Clin Pharm.  2015 Jun;25(2):80-93. 10.0000/kjcp.2015.25.2.80.

Prophylactic Effect of Pegfilgrastim on Febrile Neutropenia in Patients with Non-Hodgikin's Lymphoma

Affiliations
  • 1Graduate School of Clinical Pharmacy, Sookmyung Women's University, Seoul 140-742, South Korea. jsbang@sookmyung.ac.kr

Abstract


OBJECTIVE
Pegfilgrastim is recently introduced that is long acting G-CSF for prophylaxis of febrile neutropenia. Treatment of non-Hodgikin's lymphoma (NHL) with R-CHOP is classified with relative high risk of febrile neutropenia. The study evaluated the prophylactic effect of pegfilgrastim to reduce the incidence of febrile neutropenia associated with R-CHOP of patient in NHL. And the risk factors associated with the incidence of FN and related events were evaluated.
METHODS
This retrospective study reviews the Electronic Medical Record of 68 NHL patients who received R-CHOP chemotherapy in single center between September 2013 and August 2014. These patients were classified who receive prophylaxis pegfilgrastim or no prophylaxis.
RESULTS
Sixty eight patients received R-CHOP with NHL. In 144 cycles of patients receiving pegfilgrastim, compared with no prophylaxis 178 cycles, had a lower incidence of febrile neutropenia (5.5% vs. 23.6%, p = 0.001), grade 3 or grade 4 neutropenia (14.4% vs. 89.8%, p < 0.001) and neutropenia related events (p < 0.05). The risk of febrile neutropenia after prophylaxis was significantly associated with age > or = 65 (OR: 5.87, 95% CI 1.07-32.27, p = 0.042), IPI > or = 3 (OR: 7.2, 95% CI 1.31-39.6, p = 0.023), S.alb < 3.5 g/dL (OR: 31.01, 95% CI 6.32-152.17, p < 0.0001). In multiple logistic regression analysis, lower baseline serum albumin (OR: 21.1, 95% CI 3.8-116.98, p = 0.001) was significantly associated with occurrence of febrile neutropenia.
CONCLUSION
The study recommends prophylactic pegfilgrastim through risk assessment of febrile neutropenia in patients with non-Hodgikin's lymphoma receiving R-CHOP.

Keyword

pegfilgrastim; febrile neutropenia; non-hodgikin's lymphoma; R-CHOP regimen; granulocyte colony stimulating factor; risk factor

MeSH Terms

Drug Therapy
Electronic Health Records
Febrile Neutropenia*
Granulocyte Colony-Stimulating Factor
Humans
Incidence
Logistic Models
Lymphoma*
Neutropenia
Retrospective Studies
Risk Assessment
Risk Factors
Serum Albumin
Granulocyte Colony-Stimulating Factor
Serum Albumin
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