The prophylactic effects of long-acting granulocyte colony-stimulating factor for febrile neutropenia in newly diagnosed patients with epithelial ovarian cancer: a randomised controlled study

Abstract

ObjectiveThis study explored the prophylactic effects of long-acting granulocyte colony-stimulating factor (G-CSF) for febrile neutropenia (FN) in newly diagnosed patients with epithelial ovarian cancer (EOC).MethodsPatients were randomised into a study group (long-acting G-CSF for all chemotherapy cycles) and a control group (short-acting G-CSF for first cycle and treatment per physician discretion for subsequent cycles) at a ratio of 1:2. The incidences of FN and myelosuppression and the number of clinical visits, medication doses, complete blood count (CBC) tests and adverse events were compared between the two groups. A regression model was used to determine the risk factors for FN.ResultsFrom 30 November 2018 to 1 April 2019, 84 cases were included in the final analysis; there were 24 (28.6%) and 60 (71.4%) patients in the study and control groups, respectively, and 605 chemotherapy cycles. The study group or chemotherapy cycles utilising long-acting G-CSF had significantly fewer utilisations and doses of short-acting G-CSF; clinical visits; CBC tests; and incidences of FN and myelosuppression; and less G-CSF-associated pain. The utilisation of G-CSF was the only independent factor for FN in a binary regression model.ConclusionLong-acting G-CSF could effectively reduce the incidences of FN and myelosuppression and had mild adverse effects in newly diagnosed patients with EOC receiving chemotherapy.Trial registration number NCT03740464.

A Risk-Prediction Nomogram for Neutropenia or Febrile Neutropenia after Etoposide-Based Chemotherapy in Cancer Patients: A Retrospective Cohort Study

“…For example, ticlopidine, captopril, and cinepazide maleate, which are used to treat cardiovascular and cerebrovascular diseases, can cause neutropenia [46][47][48][49][50]. In the previous studies, there was a correlation between the use of G-CSF and the occurrence of neutropenia or FN [33,[51][52][53]. However, we did not come to the same conclusion.…”

Pegfilgrastim-induced leukocytosis and hyperleukocytosis

“…Other studies have found that using a gradual dosing scale, where incremental increase in Pegfilgrastim dose over the span of a few treatment cycles can reduce risks of AEs. [4] These studies claim that since Pegfilgrastim is intrinsically a long-acting G-CSF, prophylactic scaled dosing can gradually increase neutrophil counts to protect against FN, but simultaneously maintain an optimal clearance rate. As such, these patients can avoid some Pegfilgrastim induced AEs, including LCT and HLCT.…”

“…[2] Clinically, Pegfilgrastim is used as a primary prophylactic agent to reduce the incidence of chemotherapy-induced febrile neutropenia (FN), a poten-tially life-threatening condition. [3,4] Additionally, Neulasta has its own side effects such as pain in the extremities, bone pain, and fatigue. [3] The recommended dose of 6 mg in adults is typically given 24 hours post chemotherapy to avoid adverse effects, but simultaneously protect patients from FN.…”

PEG-rhG-CSF Use Reduces Glucose Level Significantly in Cancer Patients Receiving Chemotherapy

“…Therefore, serum concentration of rhG-CSF becomes more stable, and the elimination half-life gets prolonged [4] . Previous clinical studies showed that PEG-rhG-CSF had good efficacy and safety, and exhibited a more convenient treatment regimen than rhG-CSF [5][6][7] . In recent studies, further comparison was performed and showed that PEG-rhG-CSF is as effective and safe as rhG-CSF for prophylaxis of chemotherapy-induced neutropenia [8,9] .…”