The results of a retrospective, single-center analysis demonstrated that same-day pegfilgrastim or pegfilgrastim-cbqv was safe and effective in patients with diffuse large B-cell lymphoma who received a rituximab plus miniCHOP chemotherapy regimen, with no significant increase in febrile neutropenia or delayed engraftment.
A reduced-dose cyclophosphamide/doxorubicin/vincristine/prednisone (miniCHOP) chemotherapy regimen was used in select patients with diffuse large B-cell lymphoma (DLBCL) because of its favorable tolerance and toxicity profile. All patients treated with the miniCHOP regimen received pegfilgrastim or its biosimilar pegfilgrastim-cbqv on the same day for febrile neutropenia (FN) prophylaxis. The safety and efficacy results of a retrospective, single-center, cohort study that evaluated same-day pegfilgrastim administration in lymphoma patients receiving miniCHOP were reported at the 2021 American Society of Clinical Oncology Annual Meeting.
This retrospective study identified patients with lymphoma treated with rituximab miniCHOP (miniR-CHOP) who received pegfilgrastim or pegfilgrastim-cbqv for FN prophylaxis at the University of Arizona Cancer Center between October 1, 2013, and October 31, 2020. The primary objective of the study was to compare the incidence of FN across all cycles of chemotherapy and after the first cycle of miniR-CHOP chemotherapy in patients with DLBCL who received next-day versus same-day pegfilgrastim. Secondary outcomes were incidence of grade 3/4 chemotherapy-induced neutropenia (CIN), hospitalization, antibiotics administration, and chemotherapy dose reduction or delays.
Overall, patients received a total of 100 cycles of miniR-CHOP; of these, same-day pegfilgrastim was administered in 95 cycles and next-day pegfilgrastim was administered in 5 cycles. Across all cycles, the incidence of FN was 5.3% in the same-day pegfilgrastim cohort compared with 0.0% in the same-day pegfilgrastim cohort (P = 1.00), grade 3/4 CIN was 10.5% compared with 0.0% (P = 1.00), hospitalization was 10.5% compared with 20.0% (P = .45), antibiotics administration was 6.3% compared with 40.0% (P = .05), and chemotherapy dose delays or reductions were 16.8% compared with 0.0% (P = .99). In the first cycle of chemotherapy, the incidence of FN was 14.3% for the same-day cohort compared with 0.0% in the next-day cohort (P = 1.00), grade 3/4 CIN was 21.4% compared with 0.0% (P = 1.00), hospitalization was 28.6% compared with 25.0% (P = .99), and antibiotics administration was 21.4% compared with 50.0% (P = .53).
Based on these results, the authors concluded that same-day pegfilgrastim or pegfilgrastim-cbqv was safe and effective in patients with DLBCL who received the miniR-CHOP chemotherapy regimen, with no significant increase in FN or delayed engraftment.
Source: Bartels T, McBride A, AlRawashdh N, et al. Same-day pegfilgrastim or pegfilgrastim-cbqv prophylaxis in miniCHOP chemotherapy based regimens for non-Hodgkin lymphoma. J Clin Oncol. 2021;39(suppl_15):e19542.