Scholarlink

<p>In patients with classical Hodgkin lymphoma (c-HL) undergoing ABVD chemotherapy for advanced disease, the optimal strategy to prevent febrile neutropenia (FN)—defined as fever ≥ 38&#xa0;°C with absolute neutrophil count (ANC) &lt; 1000/mm³—remains debated. Possible prophylaxis approaches include: <i>i</i>) secondary prophylaxis with on-demand granulocyte colony-stimulating factor (G-CSF, filgrastim), <i>ii</i>) primary prophylaxis with filgrastim, or <i>iii</i>) primary prophylaxis with long-acting G-CSF formulations such as pegylated or glyco-pegylated G-CSF (lipegfilgrastim). We conducted a multicenter retrospective cohort study from 2010 to 2024 involving 450 untreated c-HL patients (Ann Arbor stage IIB-IV) scheduled for six ABVD cycles, divided into three five-year periods, each with a different G-CSF prophylaxis strategy. From 2010 to 2014, 131 patients received on-demand filgrastim when ANC ≤ 1 × 10^9/L (<i>on-demand</i>- group); from 2015 to 2019, 152 patients systematically received filgrastim six times per cycle (<i>filgrastim-</i>group); from 2020 to 2024, 167 patients received lipegfilgrastim twice per cycle as primary prophylaxis (<i>lipegfilgrastim</i>-group). A total of 85 neutropenia episodes occurred: 52 in the <i>on-demand</i>-group, 30 in the <i>filgrastim</i>-group, and 3 in the <i>lipegfilgrastim</i>-group (<i>P</i> &lt; 0.001); FN incidence was 24%, 14%, and 2%, respectively (<i>P</i> &lt; 0.0001). Chemotherapy disruptions due to FN were 14%, 6%, and 1%, respectively (<i>P</i> &lt; 0.001). Grade 3 bone pain occurred in 5% of patients and was managed with analgesics. Primary prophylaxis with lipegfilgrastim significantly reduced FN rates, hospitalizations, and chemotherapy interruptions in patients with advanced-stage c-HL treated with ABVD, demonstrating improved tolerability of chemotherapy.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Lipegfilgrastim for primary prophylaxis of febrile neutropenia in patients treated for advanced-stage classical hodgkin lymphoma: successful outcomes from a multicenter cohort study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月18日

查看全文
  • Claudia Giordano,
  • M. Picardi,
  • F. Esposito,
  • A. Vincenzi,
  • N. Pugliese,
  • A. Lombardi,
  • F. Trastulli,
  • R. Secchi,
  • M. Postorino,
  • M. Annunziata,
  • A. Venditti,
  • F. Pane

摘要

In patients with classical Hodgkin lymphoma (c-HL) undergoing ABVD chemotherapy for advanced disease, the optimal strategy to prevent febrile neutropenia (FN)—defined as fever ≥ 38 °C with absolute neutrophil count (ANC) < 1000/mm³—remains debated. Possible prophylaxis approaches include: i) secondary prophylaxis with on-demand granulocyte colony-stimulating factor (G-CSF, filgrastim), ii) primary prophylaxis with filgrastim, or iii) primary prophylaxis with long-acting G-CSF formulations such as pegylated or glyco-pegylated G-CSF (lipegfilgrastim). We conducted a multicenter retrospective cohort study from 2010 to 2024 involving 450 untreated c-HL patients (Ann Arbor stage IIB-IV) scheduled for six ABVD cycles, divided into three five-year periods, each with a different G-CSF prophylaxis strategy. From 2010 to 2014, 131 patients received on-demand filgrastim when ANC ≤ 1 × 10^9/L (on-demand- group); from 2015 to 2019, 152 patients systematically received filgrastim six times per cycle (filgrastim-group); from 2020 to 2024, 167 patients received lipegfilgrastim twice per cycle as primary prophylaxis (lipegfilgrastim-group). A total of 85 neutropenia episodes occurred: 52 in the on-demand-group, 30 in the filgrastim-group, and 3 in the lipegfilgrastim-group (P < 0.001); FN incidence was 24%, 14%, and 2%, respectively (P < 0.0001). Chemotherapy disruptions due to FN were 14%, 6%, and 1%, respectively (P < 0.001). Grade 3 bone pain occurred in 5% of patients and was managed with analgesics. Primary prophylaxis with lipegfilgrastim significantly reduced FN rates, hospitalizations, and chemotherapy interruptions in patients with advanced-stage c-HL treated with ABVD, demonstrating improved tolerability of chemotherapy.