Neutropenic events in community practices reduced by first and subsequent cycle pegfilgrastim use

Howard Ozer, Barry Mirtsching, Michael Rader, Susan Luedke, Stephen J. Noga, Beiying Ding, Lyndah Dreiling

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

The impact of first- and subsequent-cycle growth factor use in the community setting has not been studied extensively. We conducted this large, prospective, noncomparative study to assess neutropenia and related complications in patients receiving myelotoxic chemotherapy with pegfilgrastim support in community practices. Patients ≥18 years old with cancers other than leukemia or myelodysplastic syndrome, including those with major comorbidities, were eligible. Pegfilgrastim (6 mg) was to be administered ∼24 hours after chemotherapy in all cycles (minimum, four cycles). A total of 2,112 patients was included in the analyses. The most common tumor types were breast cancer (46%), non-Hodgkin's lymphoma (15%), and non-small cell lung cancer (13%). Chemotherapies administered most often were a platinum plus a taxane (18%), and anthracycline plus an alkylating agent (18%), and a taxane plus an anthracycline plus an alkylating agent (16%). The percentage of patients with neutropenia-related hospitalization was 2.9% in cycle 1 and 5.6% across all cycles. Chemotherapy dose reductions and delays were attributed to neutropenia in 1.8% and 0.9% of patients, respectively, in cycle 2 and 2.9% and 2.1% of patients, respectively, across all cycles. Febrile neutropenia (absolute neutrophil count <1.0 × 109/l with temperature ≥38.2°C) occurred in 3.6% of patients in cycle 1 and in 6.3% of patients across all cycles. The most frequently reported serious adverse events were febrile neutropenia (3.4%), neutropenia (2.6%), and dehydration (2.6%). Bone pain (0.1%) was the only related serious adverse event reported in more than one patient. Data from this communitybased study suggest that patients undergoing chemotherapy benefit from pegfilgrastim support beginning in the first cycle of chemotherapy.

Original languageEnglish (US)
Pages (from-to)484-494
Number of pages11
JournalOncologist
Volume12
Issue number4
DOIs
StatePublished - 2007

Fingerprint

Neutropenia
Drug Therapy
Febrile Neutropenia
Alkylating Agents
Anthracyclines
pegfilgrastim
Myelodysplastic Syndromes
Platinum
Dehydration
Non-Small Cell Lung Carcinoma
Non-Hodgkin's Lymphoma
Comorbidity
Neoplasms
Intercellular Signaling Peptides and Proteins
Leukemia
Hospitalization
Neutrophils
Prospective Studies
Breast Neoplasms
Bone and Bones

Keywords

  • Cancer
  • Chemotherapy
  • Community medicine
  • Febrile neutropenia
  • Medical oncology
  • Pegfilgrastim

ASJC Scopus subject areas

  • Cancer Research
  • Hematology

Cite this

Ozer, H., Mirtsching, B., Rader, M., Luedke, S., Noga, S. J., Ding, B., & Dreiling, L. (2007). Neutropenic events in community practices reduced by first and subsequent cycle pegfilgrastim use. Oncologist, 12(4), 484-494. https://doi.org/10.1634/theoncologist.12-4-484

Neutropenic events in community practices reduced by first and subsequent cycle pegfilgrastim use. / Ozer, Howard; Mirtsching, Barry; Rader, Michael; Luedke, Susan; Noga, Stephen J.; Ding, Beiying; Dreiling, Lyndah.

In: Oncologist, Vol. 12, No. 4, 2007, p. 484-494.

Research output: Contribution to journalArticle

Ozer, H, Mirtsching, B, Rader, M, Luedke, S, Noga, SJ, Ding, B & Dreiling, L 2007, 'Neutropenic events in community practices reduced by first and subsequent cycle pegfilgrastim use', Oncologist, vol. 12, no. 4, pp. 484-494. https://doi.org/10.1634/theoncologist.12-4-484
Ozer, Howard ; Mirtsching, Barry ; Rader, Michael ; Luedke, Susan ; Noga, Stephen J. ; Ding, Beiying ; Dreiling, Lyndah. / Neutropenic events in community practices reduced by first and subsequent cycle pegfilgrastim use. In: Oncologist. 2007 ; Vol. 12, No. 4. pp. 484-494.
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abstract = "The impact of first- and subsequent-cycle growth factor use in the community setting has not been studied extensively. We conducted this large, prospective, noncomparative study to assess neutropenia and related complications in patients receiving myelotoxic chemotherapy with pegfilgrastim support in community practices. Patients ≥18 years old with cancers other than leukemia or myelodysplastic syndrome, including those with major comorbidities, were eligible. Pegfilgrastim (6 mg) was to be administered ∼24 hours after chemotherapy in all cycles (minimum, four cycles). A total of 2,112 patients was included in the analyses. The most common tumor types were breast cancer (46{\%}), non-Hodgkin's lymphoma (15{\%}), and non-small cell lung cancer (13{\%}). Chemotherapies administered most often were a platinum plus a taxane (18{\%}), and anthracycline plus an alkylating agent (18{\%}), and a taxane plus an anthracycline plus an alkylating agent (16{\%}). The percentage of patients with neutropenia-related hospitalization was 2.9{\%} in cycle 1 and 5.6{\%} across all cycles. Chemotherapy dose reductions and delays were attributed to neutropenia in 1.8{\%} and 0.9{\%} of patients, respectively, in cycle 2 and 2.9{\%} and 2.1{\%} of patients, respectively, across all cycles. Febrile neutropenia (absolute neutrophil count <1.0 × 109/l with temperature ≥38.2°C) occurred in 3.6{\%} of patients in cycle 1 and in 6.3{\%} of patients across all cycles. The most frequently reported serious adverse events were febrile neutropenia (3.4{\%}), neutropenia (2.6{\%}), and dehydration (2.6{\%}). Bone pain (0.1{\%}) was the only related serious adverse event reported in more than one patient. Data from this communitybased study suggest that patients undergoing chemotherapy benefit from pegfilgrastim support beginning in the first cycle of chemotherapy.",
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