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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 Study

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Author(s)
Seong Hyun JeongSeok Jin KimDok Hyun YoonYong ParkHye Jin KangYoungil KohGyeong-Won LeeWon-Sik LeeDeok-Hwan YangYoung Rok DoMin Kyoung KimKwai Han YooYoon Seok ChoiHwan Jung YunJun Ho YiJae-Cheol JoHyeon-Seok EomJae-Yong KwakHo-Jin ShinByeong Bae ParkShin Young HyunSeong Yoon YiJi-Hyun KwonSung Yong OhHyo Jung KimByeong Seok SohnJong Ho WonSe-Hyung KimHo-Sup LeeCheolwon SuhWon Seog Kim
Keimyung Author(s)
Do, Young Rok
Department
Dept. of Internal Medicine (내과학)
Journal Title
Cancer Res Treat
Issued Date
2022
Volume
54
Issue
4
Keyword
PegfilgrastimProphylaxisDiffuse large B-cell lymphoma
Abstract
Purpose:
Febrile 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 Methods:
We 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).

Results:
Since 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.
Keimyung Author(s)(Kor)
도영록
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2005-9256
Source
https://www.e-crt.org/journal/view.php?number=3348
DOI
10.4143/crt.2021.1168
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44455
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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