Prophylactic Use of Pegfilgrastim in Patients Treated with a Nitrosourea and Teniposide for Recurrent Glioma. Issue 6 (11th March 2014)

• Record Type: Journal Article
• Authors: Thiepold, Anna‐Luisa; Lemercier, Sophie; Franz, Kea; Atta, Johannes; Sulzbacher, Annette; Steinbach, Joachim P.; Rieger, Johannes
• Is Part Of: Pharmacotherapy. Volume 34:Issue 6(2014)
• Page Start: 633
• Page End: 642
• Publication Date: 2014-03-11
• Subjects: Chemotherapy -- Periodicals; Pharmacology -- Periodicals; Drug Therapy -- Periodicals; Pharmacology -- Periodicals; 615.1
• DOI: 10.1002/phar.1409
• Languages: English
• ISSNs: 0277-0008

Abstract

<abstract abstract-type="main" id="phar1409-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="phar1409-sec-0001" sec-type="section"> <title>Study Objective</title> <p>As chemotherapy with teniposide and a nitrosourea is commonly used for the treatment of patients with recurrent glioma but can be associated with severe myelotoxicity, we sought to determine if prophylactic administration of pegfilgrastim could reduce leukopenia or infectious complications in patients receiving this chemotherapeutic regimen.</p> </sec> <sec id="phar1409-sec-0002" sec-type="section"> <title>Design</title> <p>Retrospective medical record review.</p> </sec> <sec id="phar1409-sec-0003" sec-type="section"> <title>Setting</title> <p>University‐affiliated neurooncology hospital in Frankfurt, Germany.</p> </sec> <sec id="phar1409-sec-0004" sec-type="section"> <title>Patients</title> <p>Sixty‐four patients who received at least one cycle of a nitrosourea agent (nimustine or lomustine) and teniposide for recurrent glioma between 2008 and 2012; of these patients, 28 did not receive prophylactic pegfilgrastim (cohort A), and 36 patients received prophylactic pegfilgrastim (cohort B).</p> </sec> <sec id="phar1409-sec-0005" sec-type="section"> <title>Measurements and Main Results</title> <p>Blood counts, hospitalizations due to infection or myelosuppression, use of intravenous antibiotics, and survival parameters were analyzed. Leukopenia was more frequently observed before day 30 (early nadir) versus from 30 days until the next cycle (late nadir). In cohort B, Common Terminology Criteria for Adverse Events grade 3 leukopenia in the early nadir occurred less often compared with cohort A (9% in cohort B vs 31% in cohort A). However, the frequency of grade 4 leukopenia, number of days in the hospital due to infection or myelosuppression, days on intravenous antibiotics, progression‐free survival, and overall survival were similar between the cohorts.</p> </sec> <sec id="phar1409-sec-0006" sec-type="section"> <title>Conclusion</title> <p>Moderate, but not severe, leukopenia or related complications could be prevented by prophylactic pegfilgrastim in patients treated with a nitrosourea and teniposide for recurrent glioma. Our results, therefore, do not support routine prophylactic use of pegfilgrastim in these patients.</p> </sec> </abstract>