Abstract | BACKGROUND: OBJECTIVE: METHODS: Using medical records from the Oncology Practice Pattern Study in patients treated between 1991 and 1999 at 12 sites in the United States, we studied patients with intermediate-grade NHL treated with first-line CHOP chemotherapy and prophylactic filgrastim. The number of days of prophylactic filgrastim use, mode of prophylaxis, and incidence of febrile neutropenia were evaluated. The cycles were stratified into 2 groups based on days of filgrastim prophylaxis (<7 days [Group 1] and > or = 7 days [Group 2]). RESULTS: One hundred seventy patients were treated with 652 cycles of CHOP chemotherapy with filgrastim prophylaxis. The mean days of filgrastim prophylaxis was 9.5 days (95% confidence interval [CI], 9.3-9.7 days) across all cycles, 4.7 days (95% CI, 4.5-5.0 days) across Group 1 cycles (n=73), and 10.1 days (95% CI, 9.9-10.3 days) across Group 2 cycles (n=579). Thirty-seven percent of patients were treated with primary prophylaxis; 94% of these patients. cycles were Group 2 cycles. The incidence of febrile neutropenia was 3.6% and 7.7% across cycles in patients receiving primary versus secondary prophylaxis, respectively. In patients treated with secondary prophylaxis, the incidence was 16.7% and 6.1% in Group 1 and Group 2 cycles, respectively. Multiple logistic regression modeling indicated that a lower risk of febrile neutropenia was associated with primary prophylaxis (mainly Group 2) (odds ratio [OR] 0.3; 95% CI, 0.1-0.6) and secondary prophylaxis in Group 2 (OR 0.4; 95% CI, 0.2-0.8), and lower body surface area was associated with a greater risk of febrile neutropenia (OR 1.8; 95% CI, 1.1-3.0). CONCLUSION: Primary prophylaxis with filgrastim (mainly Group 2) and secondary prophylaxis in Group 2 (mean 10.1 days) may be associated with a lower incidence of febrile neutropenia than secondary prophylaxis in Group 1.
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Authors | Shane D Scott, Elizabeth A Chrischilles, Brian K Link, David J Delgado, Moshe Fridman, Bradley S Stolshek |
Journal | Journal of managed care pharmacy : JMCP
(J Manag Care Pharm)
2003 Mar-Apr
Vol. 9
Issue 2 Suppl
Pg. 15-21
ISSN: 1083-4087 [Print] United States |
PMID | 14613340
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Recombinant Proteins
- Granulocyte Colony-Stimulating Factor
- Vincristine
- Doxorubicin
- Cyclophosphamide
- Filgrastim
- Prednisone
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Topics |
- Aged
- Antineoplastic Combined Chemotherapy Protocols
(adverse effects, therapeutic use)
- Clinical Trials as Topic
- Cyclophosphamide
(adverse effects, therapeutic use)
- Doxorubicin
(adverse effects, therapeutic use)
- Drug Administration Schedule
- Drug Utilization Review
- Female
- Fever
(chemically induced, prevention & control)
- Filgrastim
- Granulocyte Colony-Stimulating Factor
(administration & dosage, therapeutic use)
- Humans
- Lymphoma, Non-Hodgkin
(drug therapy)
- Male
- Neutropenia
(chemically induced, prevention & control)
- Prednisone
(adverse effects, therapeutic use)
- Recombinant Proteins
- Treatment Outcome
- Vincristine
(adverse effects, therapeutic use)
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