Use of pegfilgrastim primary prophylaxis and risk of infection, by chemotherapy cycle and regimen, among patients with breast cancer or non-Hodgkin’s lymphoma.

Purpose This study aims to examine granulocyte colony-stimulating factor (G-CSF) prophylaxis by cancer type, chemotherapy regimen, and cycle in a real-world setting to assess if practice conforms to clinical guidelines, which recommend G-CSF prophylaxis every cycle when a patient’s risk of febrile n...

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Publicado en:Supportive Care in Cancer Vol. 22; no. 8; pp. 2167 - 2176
Autores principales: Langeberg, Wendy J., Siozon, Conchitina C., Page, John H., Morrow, P. K., Chia, Victoria M.
Formato: Journal Article
Publicado: Springer Nature Aug2014
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
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        10.1007/s00520-014-2184-5
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        atl: Use of pegfilgrastim primary prophylaxis and risk of infection, by chemotherapy cycle and regimen, among patients with breast cancer or non-Hodgkin’s lymphoma.
      aug:
        au:
          Langeberg, Wendy J.
          Siozon, Conchitina C.
          Page, John H.
          Morrow, P. K.
          Chia, Victoria M.
        affil: Amgen, Inc., Thousand Oaks, CA, USA
      sug:
      ab: Purpose This study aims to examine granulocyte colony-stimulating factor (G-CSF) prophylaxis by cancer type, chemotherapy regimen, and cycle in a real-world setting to assess if practice conforms to clinical guidelines, which recommend G-CSF prophylaxis every cycle when a patient’s risk of febrile neutropenia (FN) is 20 % or greater, and to describe the incidence of FN among patients who discontinue pegfilgrastim (peg) prophylaxis. Methods The cohort was selected from administrative claims data and includes adults diagnosed with non-Hodgkin’s lymphoma (NHL) or breast cancer (BC) who began chemotherapy 2005–2010. Results About 83.2 % of the 4,470 patients with BC treated with dose-dense doxorubicin, cyclophosphamide (ddAC), 83.6 % of 2,197 patients with BC treated with docetaxel, doxorubicin, cyclophosphamide (TAC), and about 55.6 % of the 2,722 patients with NHL treated with cyclophosphamide, doxorubicin, vincristine, with or without prednisone for 3-week cycles (CHOP-R Q3W) received peg prophylaxis in cycle 1. Among patients on these regimens who received peg prophylaxis in cycle 1 and were still on the regimen in cycle 4, about 90 % received peg prophylaxis in that cycle. Among patients with BC or NHL who discontinued G-CSF, the incidence proportion of infection or FN varied by regimen and cycle, with a range from 0 to 14 %. Conclusions Despite clinical guidelines recommending GCSF prophylaxis with chemotherapy regimens with a high risk of FN, many NHL and BC patients do not receive FN prophylaxis in cycle 1. However, among patients who receive G-CSF in cycle 1 and remain on the regimen, the majority appear to continue prophylaxis as indicated.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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