Pegfilgrastim on febrile neutropenia in pediatric and adolescent cancer patients: a systematic review and meta-analysis.

Abstract

OBJECTIVES:

There is no meta-analysis about the effects of pegfilgrastim on the occurrence of febrile neutropenia (FN) in pediatric/adolescent cancer patients. The study explored the efficacy of prophylactic pegfilgrastim in preventing FN in children/adolescents with cancer.

METHODS:

PubMed, Embase, and the Cochrane Library were searched for studies published before April 7, 2020. The primary outcome was the rate of FN. Effect size (ES) and odds ratio (OR) with 95% confidence intervals (CIs) were used to evaluate the outcome. The ES represented the rate of FN, and the STATA 'metaprop' command was used to synthesize the rate.

RESULTS:

Eight studies were included, comprising 167 patients and 550 courses of treatment. There was no difference between pegfilgrastim and filgrastim for the rate of FN in children receiving chemotherapy (OR = 0.68, 95% CI: 0.20-2.23, P = 0.520). In patients receiving pegfilgrastim, the rate of FN was 25.6% (95% CI: 14.9%-36.3%), the rate of grade 4 FN was 38.3% (95% CI: 19.2%-59.5%), the rate of severe neutropenia (SN) was 40.5% (95% CI: 35.1%-46.1%), and the rate of treatment delays due to FN was 4.8% (95% CI: 0.8%-11.3%).

DISCUSSION:

The number of studies that could be included was small; therefore, a specific type of cancer or a specific treatment could be studied. Heterogeneity was high.

CONCLUSION:

There was no difference between pegfilgrastim and filgrastim for the rate of FN. The use of pegfilgrastim was still associated with rates of FN, grade 4 FN, severe neutropenia, and treatment delays due to FN in pediatric cancer patients.

• Authors: Xia Zhu, Weiling Zhang, Yi Zhang, Yizhuo Wang, Huimin Hu, Jing Li, Yan Zhou, Tao Han, Dongsheng Huang
• Journal: Hematology (Amsterdam, Netherlands) (Hematology) Vol. 28 Issue 1 Pg. 2172292 (Dec 2023) ISSN: 1607-8454 [Electronic] England
• PMID: 36719297 (Publication Type: Meta-Analysis, Systematic Review, Journal Article)

Chemical References

• pegfilgrastim
• Filgrastim
• Granulocyte Colony-Stimulating Factor
• Polyethylene Glycols
• Recombinant Proteins

Topics

• Humans
• Adolescent
• Child
• Filgrastim (therapeutic use)
• Granulocyte Colony-Stimulating Factor (therapeutic use)
• Polyethylene Glycols
• Neoplasms (complications, drug therapy)
• Febrile Neutropenia (chemically induced, drug therapy, prevention & control)
• Recombinant Proteins (therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols