Maintaining the dose intensity of ICE chemotherapy with a thrombopoietic agent, PEG-rHuMGDF, may confer a survival advantage in relapsed and refractory aggressive non-Hodgkin lymphoma

Moskowitz, Craig H.; Hamlin, Paul A.; Gabrilove, Janice; Bertino, Joseph R.; Portlock, Carol S.; Straus, David J.; Gencarelli, Alison; Nimer, Stephen D.; Zelenetz, Andrew D.

doi:10.1093/annonc/mdm341

Cited by 40 publications

(51 citation statements)

References 33 publications

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“…A recent follow-up of patients treated with PEGrHuMGDF supports the importance of maintaining therapy in the setting of cancer-associated chemotherapy, as improved survival could be demonstrated for patients in whom PEG-rHuMGDF allowed uninterrupted treatment [35].…”

Section: Recombinant Thrombopoietinsmentioning

confidence: 90%

Role of growth factors and thrombopoietic agents in the treatment of chronic hepatitis C

Tillmann¹,

Patel²,

McHutchison

2009

Curr Gastroenterol Rep

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Advanced liver disease and interferon-based treatment are both associated with varying degrees of cytopenia in patients with chronic hepatitis C. Growth factors to increase hemoglobin and neutrophils are commonly used in clinical practice, despite the absence of data to indicate benefits in terms of sustained viral response. Thrombocytopenia is observed frequently, is multi-factorial in etiology, and may result in significant limitations on interventional and therapeutic options. A small-molecule thrombopoietin mimetic, eltrombo-pag, has demonstrated a dose-response associated increase in platelet count in a phase 2 study, allowing initiation and completion of a 12-week course of peginterferon plus ribavirin in 36%, 53%, and 65% of patients receiving 30 mg, 50 mg, or 75 mg of eltrombopag daily, respectively, compared with 6% in the placebo arm. Phase 3 studies are currently evaluating whether initiating and maintaining antiviral therapy with eltrombopag will lead to an increase in sustained virologic response in chronic hepatitis C infection.

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Section: Recombinant Thrombopoietinsmentioning

confidence: 90%

Role of growth factors and thrombopoietic agents in the treatment of chronic hepatitis C

Tillmann¹,

Patel²,

McHutchison

2009

Curr Gastroenterol Rep

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“…PEG-MGDF did confer a survival benefit in one study of non-Hodgkin lymphoma [7]. Those on the PEG-MGDF arm had significantly higher median platelet nadirs, less grade IV thrombocytopenia, and less need for platelet transfusion.…”

Section: Tpo Agents In Chemotherapy-induced Thrombocytopeniamentioning

confidence: 98%

The new thrombopoietic agenda: Impact on leukemias and MDS

Bussel

2014

Best Practice & Research Clinical Haematology

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“…32 Three randomized trials of recombinant TPO given for autologous stem cell transplantation showed no overall benefit. 31,[62][63][64] However, the data do support a role for thrombopoietic agents in combination with G-CSF to improve mobilization of hematopoietic progenitor cells to the peripheral blood and thereby enhance yields during peripheral stem cell harvesting. 33,34 Clinical consequences of the addition of thrombopoietic agents in this setting remain unknown.…”

Section: What If the Patient Were Undergoing Nonmyeloablative Chemothmentioning

confidence: 99%

“…Other clinically relevant endpoints, such as enhanced tumor response to chemotherapy and frequency of dose reductions or delayed initiation of chemotherapy, were generally not extensively studied, although this was specifically examined by Moskowitz et al [25][26][27][28] and stem cell transplantation. [29][30][31]62 The 4 studies of recombinant TPO in patients with acute myelogenous leukemia (AML) undergoing induction and/ or consolidation chemotherapy showed no clinical benefit either in terms of ameliorating the platelet nadir or significantly reducing the need for platelet transfusion. One explanation for this difference may be that only very immature megakaryocyte progenitor cells survive the myelotoxic therapy used in leukemia treatment, and these progenitors require weeks to mature.…”

Section: What If the Patient Were Undergoing Nonmyeloablative Chemothmentioning

confidence: 99%

Novel Thrombopoietic Agents

Andemariam

Psaila²,

Bussel³

2007

Hematology

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Thrombocytopenia is a primary manifestation of immune thrombocytopenic purpura (ITP) and may occur as a result of hepatitis C, malignancy, and treatment with chemotherapy. There is a need for additional means to treat thrombocytopenia in these settings. Recombinant thrombopoietin-like agents became available after the cloning of thrombopoietin in 1994. In clinical trials, these agents showed some efficacy in chemotherapy-induced thrombocytopenia, but their use was ultimately discontinued due to the development of neutralizing antibodies that crossreacted with endogenous thrombopoietin and caused thrombocytopenia in healthy blood donors and other recipients. Subsequently, "second-generation" thrombopoietic agents without homology to thrombopoietin were developed. In the past 5 years, these second-generation thrombopoeitic growth factors have undergone substantial clinical development and have demonstrated safety, tolerability and efficacy in subjects with ITP and hepatitis C-related thrombocytopenia. These completed studies, many of which are available only in abstract form, and other ongoing studies suggest that thrombopoietic agents will enhance the hematologist's ability to manage these and other causes of thrombocytopenia.

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Maintaining the dose intensity of ICE chemotherapy with a thrombopoietic agent, PEG-rHuMGDF, may confer a survival advantage in relapsed and refractory aggressive non-Hodgkin lymphoma

Abstract: PEG-rHuMGDF ameliorated thrombocytopenia, improved platelet recovery, and maintained ICE dose intensity. Potential survival advantages conferred by maintaining dose intensity require validation with newer thrombopoietic agents.

Cited by 40 publications

References 33 publications

Role of growth factors and thrombopoietic agents in the treatment of chronic hepatitis C

Role of growth factors and thrombopoietic agents in the treatment of chronic hepatitis C

The new thrombopoietic agenda: Impact on leukemias and MDS

Novel Thrombopoietic Agents

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