Difference of preventing effects of G-CSF according to age in patients with malignant lymphoma: A nation-wide analysis in Japan.

Abstract

INTRODUCTION:

There has been no comprehensive analysis of the age-specific efficacy of G-CSF to prevent febrile neutropenia (FN). We evaluated factors associated with FN occurrence according to patient age in rituximab-cyclophosphamide-doxorubicin-vincristine-prednisolone (R-CHOP) treatment.

METHODS:

We retrospectively reviewed diffuse large B-cell lymphoma (DLBCL) patients aged ≥50 years, who underwent the first R-CHOP cycle between July 2010 and March 2017, using a Japanese inpatient database. Multivariable logistic regression analysis was performed to identify the factors associated with FN.

RESULTS:

A total of 16,399 patients with untreated DLBCL were identified. Primary prophylaxis with pegfilgrastim was significantly associated with the lower occurrence of FN (odds ratio: 0.71 [95% confidence interval: 0.51-0.99]). Subgroup analysis according to age was then performed. Although there was no significance, primary prophylaxis with pegfilgrastim tended to have a lower odds ratio for the occurrence of FN in patients aged 50-60 years (0.86 [0.39-1.89]) and 61-70 years (0.64 [0.36-1.13]). In patients aged 71-80 years, primary prophylaxis with pegfilgrastim was significantly associated with reduced FN occurrence (0.46 [0.26-0.80]). Notably, in patients aged >80 years, the use of pegfilgrastim tended to be associated with a rather higher occurrence of FN (1.55 [0.84-2.87]).

CONCLUSIONS:

Preventing effect of G-CSF may be limited in patients aged >80 years.

• Authors: Kensuke Matsuda, Taisuke Jo, Masashi Miyauchi, Kazuhiro Toyama, Kumi Nakazaki, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga, Mineo Kurokawa
• Journal: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy (J Infect Chemother) Vol. 27 Issue 8 Pg. 1151-1155 (Aug 2021) ISSN: 1437-7780 [Electronic] Netherlands
• PMID: 33745811 (Publication Type: Journal Article)
• Copyright: Copyright © 2021 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Chemical References

• Granulocyte Colony-Stimulating Factor
• Polyethylene Glycols
• Rituximab
• Vincristine
• Doxorubicin
• Cyclophosphamide

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Cyclophosphamide (adverse effects)
• Doxorubicin (therapeutic use)
• Granulocyte Colony-Stimulating Factor (therapeutic use)
• Humans
• Japan
• Lymphoma, Large B-Cell, Diffuse (drug therapy)
• Polyethylene Glycols (therapeutic use)
• Retrospective Studies
• Rituximab (therapeutic use)
• Vincristine (adverse effects)