Secondary Prophylactic G-CSF (Filgrastim) Administration in Chemotherapy of Stage I and II Hodgkin's Lymphoma with ABVD

• Published in: Leukemia & lymphoma Vol. 41; no. 3-4; pp. 353 - 358
• Main Authors: Rueda, Antonio, Sevilla, Isabel, Gumá, Josep, Ribelles, Nuria, Miramón, JosÉ, De Las Nieves, Miguel A., Márquez, Antonia, Alba, Emilio
• Format: Journal Article
• Language: English
• Published: United States Informa UK Ltd 2001; Taylor & Francis
• Subjects: Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - toxicity; bleomycin; Bleomycin - administration & dosage; Bleomycin - toxicity; chemotherapy dose-intensity; Cohort Studies; dacarbazine; Dacarbazine - administration & dosage; Dacarbazine - toxicity; doxorubicin; Doxorubicin - administration & dosage; Doxorubicin - toxicity; Female; Filgrastim; Follow-Up Studies; Granulocyte Colony-Stimulating Factor - administration & dosage; Granulocyte Colony-Stimulating Factor - toxicity; Hodgkin Disease - complications; Hodgkin Disease - drug therapy; Hodgkin's lymphoma; Humans; Male; Middle Aged; Neoplasm Staging; Prospective Studies; Recombinant Proteins; Treatment Outcome; vinblastine; Vinblastine - administration & dosage; Vinblastine - toxicity
• ISSN: 1042-8194; 1029-2403
• DOI: 10.3109/10428190109057990

The purpose of this study was to determine the effect of granulocyte colony-stimulating factor (filgrastim, G-CSF) for maintenance of chemotherapy dose-intensity in patients with stage I or II Hodgkin's lymphoma treated with six cycles of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD).
Fifty-six patients with stage I or II Hodgkin's lymphoma treated with ABVD were eligible for secondary prophylactic G-CSF administration because of neutropenia (absolute neutrophil count < 1 × 109/L) causing treatment delay or febrile neutropenia. Patients received 300 μg (total dose) of G-CSF (filgrastim) subcutaneously on days 3 to 7 and 17 to 21 of each cycle in order to prevent dose reduction or delay in subsequent cycles of treatment continuing the G-CSF until completion of chemotherapy. Results showed that 30 (54%) of the patients required the use of G-CSF, 26 (47%) during the first or second cycle. After G-CSF administration delay in chemotherapy did not occur in 25 patients, whereas delays in the fifth or sixth cycle occurred in four patients. Despite treatment with G-CSF, one patient had febrile neutropenia. Dose intensity greater than 90% of that planned was delivered to more the 85% of patients.
In conclusion: Secondary prophylactic G-CSF administration was necessary in more than half of patients with stage I or II Hodgkin's lymphoma during chemotherapy with ABVD. The use of G-CSF allowed maintenance of chemotherapy schedule and dose intensity in the majority of patients.