Comparison of Pegfilgrastim and Filgrastim for the Primary Prophylactic Effect for Preventing Febrile Neutropenia in Patients Undergoing Rituximab with Dose-adjusted EPOCH Chemotherapy

Abstract

The combination of dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide and doxorubicin with rituximab (DA-EPOCH-R) is used for non-Hodgkin lymphoma patients. Febrile neutropenia (FN) is a common complication of treatment with myelo-suppressive chemotherapy, so preventing FN is important for maintaining chemotherapy dosage. Recently, pegˆlgrastim has been used as the primary prophylaxis of FN in Japan, but there have been few cases reported using pegˆlgrastim for the primary prophylaxis in DA-EPOCH-R. In this study, we retrospectively compared the e‹cacy of pegˆlgrastim with that ofˆlgrastim in patients receiving DA-EPOCH-R in Hiroshima University Hospital. E‹cacy assessment was based on incidence of FN and serious neutropenia (neutrophil count ＜ 500/mL), hospitalization days and chemotherapy dosage level. Ten patients met the inclusion criteria: pegˆlgrastim (n ＝ 5, 30 cycles) orˆlgrastim (n ＝ 5, 16 cycles). No diŠerence in e‹cacy existed between pegˆlgrastim andˆlgrastim in theˆrst cycle; however, 2 of 5 patients inˆlgrastim group reduced dose level in the total cycles of chemotherapy, no patients in peglgrastim group reduced. In conclusion, pegˆlgrastim seemed better thanˆlgrastim for the primary prophylaxis in DA-EPOCH-R.