Primary prophylaxis with G-CSF may improve outcomes in patients with newly diagnosed stage III/IV Hodgkin lymphoma treated with brentuximab vedotin plus chemotherapy. Issue 12 (14th October 2020)

• Record Type: Journal Article
• Authors: Straus, David; Collins, Graham; Walewski, Jan; Zinzani, Pier Luigi; Grigg, Andrew; Sureda, Anna; Illes, Arpad; Kim, Tae Min; Alekseev, Sergey; Specht, Lena; Buccheri, Valeria; Younes, Anas; Connors, Joseph; Forero-Torres, Andres; Fenton, Keenan; Gautam, Ashish; Purevjal, Indra; Liu, Rachael; Gallamini, Andrea
• Is Part Of: Leukemia & lymphoma. Volume 61:Issue 12(2020)
• Page Start: 2931
• Page End: 2938
• Publication Date: 2020-10-14
• Subjects: Hodgkin lymphoma -- brentuximab vedotin -- frontline therapy -- growth factor -- primary prophylaxis; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2020.1791846
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: We investigate the impact of granulocyte-colony stimulating factor (G-CSF) primary prophylaxis (G-PP, N = 83) versus no G-PP ( N = 579) on safety and efficacy of brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A + AVD) in the ECHELON-1 study of previously untreated stage III/IV classical Hodgkin lymphoma. G-PP was associated with lower incidence of ≥ grade 3 neutropenia (29% versus 70%) and febrile neutropenia (11% versus 21%). Fewer dose delays (35% versus 49%), reductions (20% versus 26%), and hospitalizations (29% versus 38%) were observed. Seven neutropenia-associated deaths occurred in the A + AVD arm; none received G-PP. A + AVD with G-PP was associated with decreased risk of a modified progression-free survival event by 26% compared with A + AVD alone (95% CI: 0.40–1.37). G-PP reduced the rate and severity of adverse events, including febrile neutropenia, reduced treatment delays, dose reductions, and discontinuations, and may thus improve efficacy outcomes. These data support G-PP for all patients treated with A + AVD.