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Effectiveness of pegfilgrastim prophylaxis in preventing febrile neutropenia during R-FC chemoimmunotherapy for chronic lymphocytic leukemia: A multicenter prospective phase II study
- Title
- Effectiveness of pegfilgrastim prophylaxis in preventing febrile neutropenia during R-FC chemoimmunotherapy for chronic lymphocytic leukemia: A multicenter prospective phase II study
- Authors
- Jeon, Youngwoo; Yang, Duk-Hwan; Oh, Suk-Joong; Park, Jin-Hee; Kim, Jung-Ah; Kim, Sung-Young; Choi, Chul-Won; Lee, Won-Sik; Kim, In-Ho; Mun, Yeung-Chul; Min, Gi June; Eom, Ki-Seong; Cho, Seok-Goo
- Ewha Authors
- 문영철
- SCOPUS Author ID
- 문영철
- Issue Date
- 2023
- Journal Title
- FRONTIERS IN ONCOLOGY
- ISSN
- 2234-943X
- Citation
- FRONTIERS IN ONCOLOGY vol. 13
- Keywords
- prophylaxis; neutropenia; pegfilgrastim; chronic lymphocytic leukemia; R-FC regimen
- Publisher
- FRONTIERS MEDIA SA
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- BackgroundA chemotherapy of rituximab, fludarabine and cyclophosphamide (R-FC) has been accepted as a promising frontline chemotherapy in selected patients with chronic lymphocytic leukemia (CLL). Although R-FC regimen is a relatively dose-dense regimen and neutropenia incidence is more than 50%, primary prophylactic pegfilgrastim was not fully recommended in the clinical field. Therefore, the study evaluated the prophylactic effectiveness of pegfilgrastim to reduce the incidence of febrile neutropenia associated with R-FC of patients with CLL. Patients and methodsA single-arm, multicenter, prospective phase II study was designed to assess the efficacy of prophylactic pegfilgrastim. Thirty-four CLL patients were enrolled and analyzed for neutropenia and other related factors, and comparative analysis was performed with historical cohort. ResultsCompared with our historical cohort, incidence of grade 3-4 neutropenia and febrile neutropenia was remarkably reduced during any cycle of chemotherapy (14.7% vs. 48.2% of study cohort vs. historical cohort during C1, 5.9% vs. 65.8% during C2, 12.9% vs. 80.6% during C3, 10% vs. 84.6% during C4, 3.4% vs. 83.6% during C5, and 10.7% vs. 85.7% during C6, p <0.001). Also, cumulative incidence of disrupted chemotherapy was noticeably reduced in study cohort on any cycles of R-FC regimen (8.8% vs. 22.2% of study cohort vs. historical cohort on C2, 9.7% vs. 25.2% on C3, 13.4% vs. 26.9% on C4, 13.8% vs. 45.2% on C5, 17.9% vs. 47.3% on C6, p=0.007). In addition, treatment-related mortality was 5.9%, which significantly reduced compared to 9.6% of our historical cohort (HR 0.64, 95% CI 0.42-0.79, P = 0.032). ConclusionPrimary prophylactic pegfilgrastim is effective in the prevention of neutropenia/febrile neutropenia, and infection-related mortality during R-FC regimen in patients with CLL.
- DOI
- 10.3389/fonc.2023.998014|http://dx.doi.org/10.3389/fonc.2023.998014
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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