Pegfilgrastim Prophylaxis Is Effective in the Prevention of Febrile Neutropenia and Reduces Mortality in Patients Aged ≥ 75 Years with Diffuse Large B-Cell Lymphoma Treated with R-CHOP: A Prospective Cohort Studyopen access
- Authors
- 정성현; 김석진; 윤덕현; 박용; 강혜진; 고영일; 이경원; 이원식; 양덕환; 도영록; 김민경; 유쾌한; 최윤석; 윤환정; 이준호; 조재철; 엄현석; 곽재용; 신호진; 박병배; 현신영; 이성윤; 권지현; 오성용; 김효정; 손병석; 원종호; 김세형; 이호섭; 서철원; 김원석
- Issue Date
- Oct-2022
- Publisher
- 대한암학회
- Keywords
- Pegfilgrastim; Prophylaxis; Diffuse large B-cell lymphoma
- Citation
- Cancer Research and Treatment, v.54, no.4, pp.1268 - 1277
- Journal Title
- Cancer Research and Treatment
- Volume
- 54
- Number
- 4
- Start Page
- 1268
- End Page
- 1277
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/86622
- DOI
- 10.4143/crt.2021.1168
- ISSN
- 1598-2998
- Abstract
- PurposeFebrile neutropenia (FN) can cause suboptimal treatment and treatment-related mortality (TRM) in diffuse large B-cell lymphoma (DLBCL) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP). Materials and methodsWe conducted a prospective cohort study to evaluate the effectiveness of pegfilgrastim prophylaxis in DLBCL patients receiving R-CHOP, and we compared them with the PROCESS cohort (n=485). ResultsSince January 2015, 986 patients with DLBCL were enrolled. Pegfilgrastim was administered at least once in 930 patients (94.3%), covering 90.3% of all cycles. FN developed in 137 patients (13.9%) in this cohort (23.7% in the PROCESS cohort, p<0.001), and 4.2% of all cycles (10.2% in the PROCESS cohort, p<0.001). Dose delay was less common (≥3 days: 18.1% vs. 23.7%, p=0.015; ≥5 days: 12.0% vs. 18.3%, p=0.023) in this cohort than in the PROCESS cohort. The incidence of TRM (3.2% vs. 5.6%, p=0.047) and infection-related death (1.8% vs. 4.5%, p=0.004) was lower in this cohort than in the PROCESS cohort. The 4-year overall survival (OS) and progression-free survival (PFS) rates of the two cohorts were not different (OS: 73.0% vs. 71.9%, p=0.545; PFS: 69.5% vs. 68.8%, p=0.616). However, in patients aged ≥75 years, the 4-year OS and PFS rates were higher in this cohort than in the PROCESS cohort (OS: 49.6% vs. 33.7%, p=0.032; PFS: 44.2% vs. 30.3% p=0.047). Conclusion Pegfilgrastim prophylaxis is effective in the prevention of FN and infection-related death in DLBCL patients receiving R-CHOP, and it also improves OS in patients aged ≥75 years.
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