Pegfilgrastim in Pediatric Cancer Patients

Poele, Esther M. te; Kamps, Willem A.; Tamminga, R. Y. J.; Leeuw, Jan A.; Postma, A.; Bont, E. S. J. M. de

doi:10.1097/01.mph.0000188631.41510.23

Cited by 32 publications

(33 citation statements)

References 12 publications

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“…1 Only three papers regarding the use of PEG in children have been published to date, and they all only analysed PEG efficacy in haematological recovery. [12][13][14] These reports state that PEG can be safely administered to children and that the duration of severe neutropaenia and the incidence of FN were comparable to those occurring after filgrastim. One paper reported a delay in treatment caused by persistent neutropaenia in 6% of patients.…”

Section: Discussionmentioning

confidence: 78%

“…The same author reported that the main limiting factor related to the timely administration of the subsequent cycle of chemotherapy was thrombocytopaenia, which may have been an unwanted side effect of PEG in one-fourth of cases. 12 Children with poor-risk cancer, responding to first-line therapy or even to rescue therapy are often consolidated with high-dose chemotherapy followed by autologous PBMC transplantation. In this setting, filgrastim is the drug of choice for enhancing PBMC collection after myelosuppressive, mobilizing chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

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Prospective single-arm study of pegfilgrastim activity and safety in children with poor-risk malignant tumours receiving chemotherapy

Dallorso

Berger

Caviglia

et al. 2008

Bone Marrow Transplant

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The objective of this study was to assess the efficacy of an injection of 100 lg/kg of pegfilgrastim in haematopoietic recovery and mobilization in children following 32 courses of chemotherapy. End points were duration of neutropaenia, myeloid recovery and PBMC collection. Neutropaenia lasted a mean of 4.7 days ( ± 2.13 days). Myeloid recovery occurred at a median of 10 days (inter quartile range (IQR) 8-11). Febrile neutropaenia complicated 13 courses (40.6%). Mobilization was observed in 20 out of 26 assessable courses (76.9%). The rise in CD34 þ cells occurred at a median of 6 days (IQR 4-7) after PEG and remained 420 per ll for 6 days (IQR 4-8), with a median value of 80 per ll (IQR 48-170.5). The median CD34 þ cell peak was 165 per ll (IQR 82.5-331), 9 days (range 6-14) after PEG. PBMC were collected on average at day þ 5 ( þ 4 to þ 9) after PEG. In 93.3% of collections, at least 3 Â 10 6 per kg CD34 þ cells were collected through a single apheresis. Myeloid recovery occurred in all cases within 15 days, without concomitant thrombocytopaenia. The incidence of primary febrile episodes is in line with data in the literature and with our own historical experience. A long-lasting period of circulating CD34 þ cells allowed for more accurate scheduling of apheresis.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Prospective single-arm study of pegfilgrastim activity and safety in children with poor-risk malignant tumours receiving chemotherapy

Dallorso

Berger

Caviglia

et al. 2008

Bone Marrow Transplant

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“…In adult patients, a single-dose of 100 µg/kg, as well as a fixed dose of pegfilgrastim 6 mg per chemotherapy cycle was shown to be at least as effective as one dose of filgrastim (5 µg/kg) per day over an average of 11 days [99,100]. In pediatric cancer patients, the use of pegfilgrastim at a dosage of 100 µg/kg seems to well tolerated and without short-term adverse effects [101][102][103]. One study compared the efficacy of pegfilgrastim and filgrastim in five patients (58 chemotherapy cycles) without observing major differences [101].…”

Section: Pediatric Experience With Pegylated G-csfmentioning

confidence: 99%

Myeloid growth factors as anti-infective measures in children with leukemia and lymphoma

Lehrnbecher¹,

Creutzig²

2009

Expert Review of Hematology

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Clinical trials in children treated for leukemia and lymphoma demonstrated that the hematopoietic colony-stimulating factors (CSFs) granulocyte (G) and granulocyte-macrophage (GM) CSFs ameliorate duration and depth of neutropenia, and also seem to decrease antibiotic usage and hospitalization. However, neither G-CSF nor GM-CSF significantly reduced the risk for infectious complications, such as febrile neutropenia or documented infections, or improved overall survival in these patient populations. Since it is unclear whether G- and GM-CSF may increase the risk for relapse in subgroups of patients with leukemia, guidelines recommend that hematopoietic growth factors should be used with caution in children with leukemia and lymphoma.

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“…[5][6][7] In children, the data on pegfilgrastim are very limited and refer to the prevention and treatment of chemotherapy-induced neutropenia and chemo-induced stem cell mobilization. [8][9][10][11] The objective of this phase IIA study was to evaluate the percentage of children achieving steady-state mobilization of HPCs using pegfilgrastim, that is, an optimal harvest of 5 Â 10 6 CD34 þ cells/kg in one standard apheresis (p3 blood volumes processed (BVP)) after a single injection of 300 mg/kg pegfilgrastim.…”

Section: Introductionmentioning

confidence: 99%

Hematopoietic progenitor cell mobilization and harvesting in children with malignancies: do the advantages of pegfilgrastim really translate into clinical benefit?

Merlin

Zohar

Jérome³

et al. 2008

Bone Marrow Transplant

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International audienceOur purpose was to assess success rates in children of achieving optimal hematopoietic progenitor cells (HPCs) harvest after mobilization with 300 microg/kg pegfilgrastim. Between January 2005 and January 2007, 26 children with solid malignancies who were referred for HPC collection were consecutively included. Hematopoietic progenitor cell mobilization consisted of one s.c. injection of 300 microg/kg body weight (BW) of pegfilgrastim. The success criterion was defined as at least 5 x 10(6) CD34+ cells/kg during the first standard apheresis (less than 3 blood volumes processed (BVP)). After 26 inclusions, the Bayesian analysis gave a mean estimated success rate of 60.7% (95% credibility interval: 42.0-78.0%). The first apheresis allowed the collection of 8.3 x 10(6) CD34+ cells/kg BW (range 0.6-37.8), with a median of 2.8 BVP (range 1.4-3.0). Overall, the median of CD34+ cells collected was 12.4 x 10(6)/kg (range 2.7-37.8). The cumulative dose of anthracyclin was the only variable associated with the total number of CD34+ collected cells (P<0.05). Mobilization was clinically well tolerated in 20 patients. No drug-related adverse events of grade > or =3 occurred. We conclude that a single injection of 300 microg/kg pegfilgrastim in the hematological steady state is an efficient and well-tolerated method of HPC mobilization in children with solid malignancies

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Pegfilgrastim in Pediatric Cancer Patients

Cited by 32 publications

References 12 publications

Prospective single-arm study of pegfilgrastim activity and safety in children with poor-risk malignant tumours receiving chemotherapy

Prospective single-arm study of pegfilgrastim activity and safety in children with poor-risk malignant tumours receiving chemotherapy

Myeloid growth factors as anti-infective measures in children with leukemia and lymphoma

Hematopoietic progenitor cell mobilization and harvesting in children with malignancies: do the advantages of pegfilgrastim really translate into clinical benefit?

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