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01-11-2024 | Research

Clinical effect of prophylactic pegfilgrastim in patients with newly diagnosed acute lymphoblastic leukemia who receive intensive chemotherapy

Authors: Yunji Lee, Youngeun Jang, Jung Min Lee, Hee Jeong Cho, Joon Ho Moon, Sang Kyun Sohn, Ji Yeon Ham, Soon Hee Chang, Dong Won Baek

Published in: Supportive Care in Cancer | Issue 11/2024

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Abstract

Background

Using granulocyte colony-stimulating factor (G-CSF) after completing chemotherapy reduces the duration of neutropenia and infections. However, the efficacy and safety of prophylactic pegfilgrastim in acute lymphoblastic leukemia (ALL) patients have not yet been evaluated after intensive cytotoxic chemotherapy compared to the daily G-CSF. This study aimed to evaluate the efficacy of pegfilgrastim for ALL patients who received intensive chemotherapy compared with a short-acting G-CSF.

Patients and methods

Clinical data of 145 patients treated with hyper-CVAD, modified VPDL/VPD, or KALLA 1406/1407 regimen were retrospectively evaluated. Pegfilgrastim or the short-acting G-CSF was selected according to the clinician’s discretion. Patients not receiving pegfilgrastim were treated with the short-acting G-CSF.

Results

The median age of enrolled patients was 45 years. Sixty newly diagnosed ALL patients were treated with hyper-CVAD regimen, while KALLA and VPDL regimens were administered to 39 and 46 patients, respectively. Among the 60 patients treated with hyper-CVAD, 20 patients received pegfilgrastim. Patients who received pegfilgrastim had a significantly shorter duration of neutropenia and hospitalization and reduced incidence of severe infections compared to patients receiving the short-acting G-CSF. Consistent results were also confirmed in an analysis targeting only patients who achieved remission during hyper-CVAD induction therapy. There was no significant difference in neutrophil recovery ability and hospitalization duration when the daily short-acting G-CSF was used prophylactically after completing hyper-CVAD, KALLA, and VPDL regimens as induction therapy.

Conclusion

Using pegfilgrastim after hyper-CVAD therapy was more effective than the short-acting G-CSF in terms of infection, neutropenia recovery, and hospitalization in patients with newly diagnosed ALL.
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Metadata
Title
Clinical effect of prophylactic pegfilgrastim in patients with newly diagnosed acute lymphoblastic leukemia who receive intensive chemotherapy
Authors
Yunji Lee
Youngeun Jang
Jung Min Lee
Hee Jeong Cho
Joon Ho Moon
Sang Kyun Sohn
Ji Yeon Ham
Soon Hee Chang
Dong Won Baek
Publication date
01-11-2024
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 11/2024
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-024-08926-0

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