Cargando…

Trajectory of absolute neutrophil counts in patients treated with pegfilgrastim on the day of chemotherapy versus the day after chemotherapy

PURPOSE: Risk of infection increases with severity and duration of chemotherapy-induced neutropenia (CIN). Pegfilgrastim is approved for use on the day after chemotherapy to reduce incidence of infection, as manifested by febrile neutropenia (FN), in patients receiving myelosuppressive chemotherapy....

Descripción completa

Detalles Bibliográficos
Autores principales: Li, Yanli, Klippel, Zandra, Shih, Xiaolong, Wang, Hong, Reiner, Maureen, Page, John H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4819939/
https://www.ncbi.nlm.nih.gov/pubmed/26886017
http://dx.doi.org/10.1007/s00280-016-2970-5
_version_ 1782425317184372736
author Li, Yanli
Klippel, Zandra
Shih, Xiaolong
Wang, Hong
Reiner, Maureen
Page, John H.
author_facet Li, Yanli
Klippel, Zandra
Shih, Xiaolong
Wang, Hong
Reiner, Maureen
Page, John H.
author_sort Li, Yanli
collection PubMed
description PURPOSE: Risk of infection increases with severity and duration of chemotherapy-induced neutropenia (CIN). Pegfilgrastim is approved for use on the day after chemotherapy to reduce incidence of infection, as manifested by febrile neutropenia (FN), in patients receiving myelosuppressive chemotherapy. In this study, we compared severity and duration of absolute neutrophil count (ANC) suppression in patients who received pegfilgrastim on the same day as chemotherapy versus the next day. METHODS: We combined individual patient data from four Amgen-sponsored clinical trials in which patients with cancer were randomized to receive pegfilgrastim either the same day as chemotherapy or the next day. Severity and duration of ANC suppression were calculated using area over the curve (AOC, the area over the ANC–time response curve and below a given clinical threshold). AOC of ANC and incidences of CIN and FN were compared by day of pegfilgrastim use. RESULTS: The analysis included 95 same-day patients and 97 next-day patients. Despite similar ANC at baseline, ANC at nadir was higher among next-day patients than same-day patients. Mean AOC of ANC (cutoff 0.5 × 10(9)/L) among next-day patients was lower by 0.30 (95 % confidence interval: 0.16, 0.43) 10(9)/L × day than same-day patients in cycle 1. Next-day patients had lower incidences of CIN than same-day patients, but there were no significant differences in incidences of FN. CONCLUSIONS: Patients who received pegfilgrastim the day after chemotherapy had less severe and shorter suppression of ANC than patients who received pegfilgrastim the same day as chemotherapy. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00280-016-2970-5) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-4819939
institution National Center for Biotechnology Information
language English
publishDate 2016
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-48199392016-04-11 Trajectory of absolute neutrophil counts in patients treated with pegfilgrastim on the day of chemotherapy versus the day after chemotherapy Li, Yanli Klippel, Zandra Shih, Xiaolong Wang, Hong Reiner, Maureen Page, John H. Cancer Chemother Pharmacol Original Article PURPOSE: Risk of infection increases with severity and duration of chemotherapy-induced neutropenia (CIN). Pegfilgrastim is approved for use on the day after chemotherapy to reduce incidence of infection, as manifested by febrile neutropenia (FN), in patients receiving myelosuppressive chemotherapy. In this study, we compared severity and duration of absolute neutrophil count (ANC) suppression in patients who received pegfilgrastim on the same day as chemotherapy versus the next day. METHODS: We combined individual patient data from four Amgen-sponsored clinical trials in which patients with cancer were randomized to receive pegfilgrastim either the same day as chemotherapy or the next day. Severity and duration of ANC suppression were calculated using area over the curve (AOC, the area over the ANC–time response curve and below a given clinical threshold). AOC of ANC and incidences of CIN and FN were compared by day of pegfilgrastim use. RESULTS: The analysis included 95 same-day patients and 97 next-day patients. Despite similar ANC at baseline, ANC at nadir was higher among next-day patients than same-day patients. Mean AOC of ANC (cutoff 0.5 × 10(9)/L) among next-day patients was lower by 0.30 (95 % confidence interval: 0.16, 0.43) 10(9)/L × day than same-day patients in cycle 1. Next-day patients had lower incidences of CIN than same-day patients, but there were no significant differences in incidences of FN. CONCLUSIONS: Patients who received pegfilgrastim the day after chemotherapy had less severe and shorter suppression of ANC than patients who received pegfilgrastim the same day as chemotherapy. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00280-016-2970-5) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2016-02-17 2016 /pmc/articles/PMC4819939/ /pubmed/26886017 http://dx.doi.org/10.1007/s00280-016-2970-5 Text en © The Author(s) 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Li, Yanli
Klippel, Zandra
Shih, Xiaolong
Wang, Hong
Reiner, Maureen
Page, John H.
Trajectory of absolute neutrophil counts in patients treated with pegfilgrastim on the day of chemotherapy versus the day after chemotherapy
title Trajectory of absolute neutrophil counts in patients treated with pegfilgrastim on the day of chemotherapy versus the day after chemotherapy
title_full Trajectory of absolute neutrophil counts in patients treated with pegfilgrastim on the day of chemotherapy versus the day after chemotherapy
title_fullStr Trajectory of absolute neutrophil counts in patients treated with pegfilgrastim on the day of chemotherapy versus the day after chemotherapy
title_full_unstemmed Trajectory of absolute neutrophil counts in patients treated with pegfilgrastim on the day of chemotherapy versus the day after chemotherapy
title_short Trajectory of absolute neutrophil counts in patients treated with pegfilgrastim on the day of chemotherapy versus the day after chemotherapy
title_sort trajectory of absolute neutrophil counts in patients treated with pegfilgrastim on the day of chemotherapy versus the day after chemotherapy
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4819939/
https://www.ncbi.nlm.nih.gov/pubmed/26886017
http://dx.doi.org/10.1007/s00280-016-2970-5
work_keys_str_mv AT liyanli trajectoryofabsoluteneutrophilcountsinpatientstreatedwithpegfilgrastimonthedayofchemotherapyversusthedayafterchemotherapy
AT klippelzandra trajectoryofabsoluteneutrophilcountsinpatientstreatedwithpegfilgrastimonthedayofchemotherapyversusthedayafterchemotherapy
AT shihxiaolong trajectoryofabsoluteneutrophilcountsinpatientstreatedwithpegfilgrastimonthedayofchemotherapyversusthedayafterchemotherapy
AT wanghong trajectoryofabsoluteneutrophilcountsinpatientstreatedwithpegfilgrastimonthedayofchemotherapyversusthedayafterchemotherapy
AT reinermaureen trajectoryofabsoluteneutrophilcountsinpatientstreatedwithpegfilgrastimonthedayofchemotherapyversusthedayafterchemotherapy
AT pagejohnh trajectoryofabsoluteneutrophilcountsinpatientstreatedwithpegfilgrastimonthedayofchemotherapyversusthedayafterchemotherapy