Comparison between a single dose of PEG G-CSF and multiple doses of non-PEG G-CSF: a systematic review and meta-analysis from Clinical Practice Guidelines for the use of G-CSF 2022

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发表日期：

2024年4月23日

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Tetsuhiro Yoshinami,
Kazuki Nozawa,
Takamichi Yokoe,
Yukinori Ozaki,
Hiroshi Nishio,
Kenji Tsuchihashi,
Eiki Ichihara,
Yuji Miura,
Makoto Endo,
Shingo Yano,
Dai Maruyama,
Nobuyuki Susumu,
Munetaka Takekuma,
Takashi Motohashi,
Mamoru Ito,
Eishi Baba,
Nobuaki Ochi,
Toshio Kubo,
Keita Uchino,
Takahiro Kimura,
Yutaro Kamiyama,
Shinji Nakao,
Shinobu Tamura,
Hitomi Nishimoto,
Yasuhisa Kato,
Atsushi Sato,
Toshimi Takano

摘要

Backgroud

Granulocyte colony-stimulating factor (G-CSF) is widely used for the primary prophylaxis of febrile neutropenia (FN). Two types of G-CSF are available in Japan, namely G-CSF chemically bound to polyethylene glycol (PEG G-CSF), which provides long-lasting effects with a single dose, and non-polyethylene glycol-bound G-CSF (non-PEG G-CSF), which must be sequentially administrated for several days.

Methods

This current study investigated the utility of these treatments for the primary prophylaxis of FN through a systematic review of the literature. A detailed literature search for related studies was performed using PubMed, Ichushi-Web, and the Cochrane Library. Data were independently extracted and assessed by two reviewers. A qualitative analysis or meta-analysis was conducted to evaluate six outcomes.

Results

Through the first and second screenings, 23 and 18 articles were extracted for qualitative synthesis and meta-analysis, respectively. The incidence of FN was significantly lower in the PEG G-CSF group than in the non-PEG G-CSF group with a strong quality/certainty of evidence. The differences in other outcomes, such as overall survival, infection-related mortality, the duration of neutropenia (less than 500/μL), quality of life, and pain, were not apparent.

Conclusions

A single dose of PEG G-CSF is strongly recommended over multiple-dose non-PEG G-CSF therapy for the primary prophylaxis of FN.