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KMID : 0941820150250020080
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Korean Journal of Clinical Pharmacy
2015 Volume.25 No. 2 p.80 ~ p.93
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Prophylactic Effect of Pegfilgrastim on Febrile Neutropenia in Patients with Non-Hodgikin’s Lymphoma
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Jo Ju-Hee
Bang Joon-Seok
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Abstract
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Objective: Pegfilgrastim is recently introduced that is long acting G-CSF for prophylaxis of febrile neutropenia. Treatment of non-Hodgikin’s lymphoma (NHL) with R-CHOP is classified with relative high risk of febrile neutropenia. The study evaluated the prophylactic effect of pegfilgrastim to reduce the incidence of febrile neutropenia associated with R-CHOP of patient in NHL. And the risk factors associated with the incidence of FN and related events were evaluated.
Methods: This retrospective study reviews the Electronic Medical Record of 68 NHL patients who received R-CHOP chemotherapy in single center between September 2013 and August 2014. These patients were classified who receive prophylaxis pegfilgrastim or no prophylaxis.
Results: Sixty eight patients received R-CHOP with NHL. In 144 cycles of patients receiving pegfilgrastim, compared with no prophylaxis 178 cycles, had a lower incidence of febrile neutropenia (5.5% vs. 23.6%, p = 0.001), grade 3 or grade 4 neutropenia (14.4% vs. 89.8%, p < 0.001) and neutropenia related events (p < 0.05). The risk of febrile neutropenia after prophylaxis was significantly associated with age ≥ 65 (OR: 5.87, 95% CI 1.07-32.27, p = 0.042), IPI ≥ 3 (OR: 7.2, 95% CI 1.31-39.6, p = 0.023), S.alb < 3.5 g/dL (OR: 31.01, 95% CI 6.32-152.17, p < 0.0001). In multiple logistic regression analysis, lower baseline serum albumin (OR: 21.1, 95% CI 3.8-116.98, p =0.001) was significantly associated with occurrence of febrile neutropenia.
Conclusion: The study recommends prophylactic pegfilgrastim through risk assessment of febrile neutropenia in patients with non-Hodgikin’s lymphoma receiving R-CHOP.
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KEYWORD
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pegfilgrastim, febrile neutropenia, non-hodgikin’s lymphoma, R-CHOP regimen, granulocyte colony stimulating factor, risk factor
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