Pegfilgrastim Prophylaxis Is Effective in the Prevention of Febrile Neutropenia and Reduces Mortality in Patients Aged ≥ 75 Years with Diffuse Large B-Cell Lymphoma Treated with R-CHOP: A Prospective Cohort Study
- Author:
Seong Hyun JEONG
1
;
Seok Jin KIM
;
Dok Hyun YOON
;
Yong PARK
;
Hye Jin KANG
;
Youngil KOH
;
Gyeong-Won LEE
;
Won-Sik LEE
;
Deok-Hwan YANG
;
Young Rok DO
;
Min Kyoung KIM
;
Kwai Han YOO
;
Yoon Seok CHOI
;
Hwan Jung YUN
;
Jun Ho YI
;
Jae-Cheol JO
;
Hyeon-Seok EOM
;
Jae-Yong KWAK
;
Ho-Jin SHIN
;
Byeong Bae PARK
;
Shin Young HYUN
;
Seong Yoon YI
;
Ji-Hyun KWON
;
Sung Yong OH
;
Hyo Jung KIM
;
Byeong Seok SOHN
;
Jong Ho WON
;
Se-Hyung KIM
;
Ho-Sup LEE
;
Cheolwon SUH
;
Won Seog KIM
Author Information
- Publication Type:Original Article
- From:Cancer Research and Treatment 2022;54(4):1268-1277
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Febrile neutropenia (FN) can cause suboptimal treatment and treatment-related mortality (TRM) in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP).
Materials and methods:We conducted a prospective cohort study to evaluate the effectiveness of pegfilgrastim prophylaxis in DLBCL patients receiving R-CHOP, and we compared them with the PROCESS cohort (n=485).
Results:Since January 2015, 986 patients with DLBCL were enrolled. Pegfilgrastim was administered at least once in 930 patients (94.3%), covering 90.3% of all cycles. FN developed in 137 patients (13.9%) in this cohort (23.7% in the PROCESS cohort, p<0.001), and 4.2% of all cycles (10.2% in the PROCESS cohort, p<0.001). Dose delay was less common (≥3 days: 18.1% vs. 23.7%, p=0.015; ≥5 days: 12.0% vs. 18.3%, p=0.023) in this cohort than in the PROCESS cohort. The incidence of TRM (3.2% vs. 5.6%, p=0.047) and infection-related death (1.8% vs. 4.5%, p=0.004) was lower in this cohort than in the PROCESS cohort. The 4-year overall survival (OS) and progression-free survival (PFS) rates of the two cohorts were not different (OS: 73.0% vs. 71.9%, p=0.545; PFS: 69.5% vs. 68.8%, p=0.616). However, in patients aged ≥75 years, the 4-year OS and PFS rates were higher in this cohort than in the PROCESS cohort (OS: 49.6% vs. 33.7%, p=0.032; PFS: 44.2% vs. 30.3% p=0.047).
Conclusion:Pegfilgrastim prophylaxis is effective in the prevention of FN and infection-related death in DLBCL patients receiving R-CHOP, and it also improves OS in patients aged ≥75 years.
