Abstract : BACKGROUND Filgrastim decreases the time to neutrophil recovery after autologous peripheral blood s
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Abstract : BACKGROUND Filgrastim decreases the time to neutrophil recovery after autologous peripheral blood stem cell transplantation (PBSCT). We hypothesized that single-dose pegfilgrastim would mimic multiple daily doses of filgrastim resulting in an equivalent shortening of post-PBSCT neutropenia.|PATIENTS AND METHODS Patients who were eligible for PBSCT and aged gtor= 18 years were identified before high-dose chemotherapy after the harvesting and cryopreservation of peripheral blood progenitor cells (ie gt 2.5 x 10(6) CD34-positive cells/kg). Eligible patients received either standard carmustine/etoposide/cytarabine/melphalan (BEAM) or carmustine/etoposide/cytarabine/cyclophosphamide (BEAC) high-dose chemotherapy. Before high-dose chemotherapy patients were randomly assigned to receive pegfilgrastim 6 mg on day 1 (arm A) or weight-based dose-adjusted filgrastim beginning on day 1 (arm B) after transplantation until neutrophil engraftment.|RESULTS One-hundred and one patients were enrolled between April 2003 and April 2007. Three patients were not treated. Demographics were well-balanced in terms of stage at diagnosis Eastern Cooperative Oncology Group performance status histology and lines of previous therapy. Results (arm A/arm B) pertained to mean doses received (1.0/12.6) mean absolute neutrophil count recovery days (9.3/9.8) red blood cell transfusions (1.7/1.9) red blood cell transfusion units (3.1/3.8) platelet transfusions (3.1/2.8) positive blood culture rate (18/29.2) febrile neutropenia (FN 18/16.7) and duration of FN (days 7.1/6.9). Transplantation-related mortality and grade 3 or 4 adverse events were comparable between arms.|CONCLUSION: Pegfilgrastim after PBSCT appears equivalent to multiple daily doses of filgrastim. This approach might be considered in lieu of filgrastim, thus obviating the need for multiple daily injections.|
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