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Ann Hematol. 2020 Feb;99(2):331-341. doi: 10.1007/s00277-019-03901-w. Epub 2019 Dec 18.

A comparative effectiveness study of lipegfilgrastim in multiple myeloma patients after high dose melphalan and autologous stem cell transplant.

Author information

1
Stem Cell Transplant Program, Department of Hemato-Oncology and Radiotherapy, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy. dr.massimomartino@gmail.com.
2
CNR-IFC, Rome, Italy. mercedes.gori@ifc.cnr.it.
3
CNR-IFC, Research Unit of Reggio Calabria, Reggio Calabria, Italy.
4
Department of Hematology, Unità di Ricerca Biotecnologica, Cosenza, Italy.
5
Hematology Unit, Azienda Ospedaliera Regionale S. Carlo - Ospedale San Carlo, Potenza, Italy.
6
Stem Cell Transplant Program, Department of Hemato-Oncology and Radiotherapy, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy.
7
Hematology Unit, Department of Hemato-Oncology, Ospedale Annunziata, Cosenza, Italy.
8
Division of Hematology, Department of Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, Messina, Italy.
9
Department of Experimental and Clinical Medicine, Magna Græcia University, Catanzaro, Italy.
10
Pharmacy Unit, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy.
11
Hematology Unit, Department of Hemato-Oncology and Radiotherapy, Grande Ospedale Metropolitano Bianchi-Melacrino-Morelli, Reggio Calabria, Italy.
12
Hematology Unit, Azienda Ospedaliera, Papardo, Messina, Italy.
13
CNR-IFC, Rome, Italy.

Abstract

G-CSF administration after high-dose chemotherapy and autologous stem cell transplantation (ASCT) has been shown to expedite neutrophil recovery. Several studies comparing filgrastim and pegfilgrastim in the post-ASCT setting concluded that the two are at least equally effective. Lipegfilgrastim (LIP) is a new long-acting, once-per-cycle G-CSF. This multicentric, prospective study aimed to describe the use of LIP in multiple myeloma patients receiving high-dose melphalan and autologous stem cell transplantation (ASCT) and compare LIP with historic controls of patients who received short-acting agent (filgrastim [FIL]). Overall, 125 patients with a median age of 60 years received G-CSF after ASCT (80 patients LIP on day 1 post-ASCT and 45 patients FIL on day 5 post-ASCT). The median duration of grade 4 neutropenia (absolute neutrophil count [ANC] < 0.5 × 10 [9]/L) was 5 days in both LIP and FIL groups, whereas the median number of days to reach ANC ≥ 0.5 × 10 [9]/L was 10% lower in the LIP than in the FIL group (10 vs 11 days), respectively. Male sex was significantly associated with a faster ANC ≥ 0.5 × 10 [9] L response (p = 0.015). The incidence of FN was significantly lower in the LIP than in the FIL group (29% vs 49%, respectively, p = 0.024). The days to discharge after ASCT infusion were greater in patients with FN (p < 0.001). The study indicates that LIP had a shorter time to ANC recovery and is more effective than FIL for the prevention of FN in the ASCT setting.

KEYWORDS:

Autologous stem cell transplant; Filgrastim; G-CSF; High dose melphalan; Lipegfilgrastim; Multiple myeloma

PMID:
31853703
DOI:
10.1007/s00277-019-03901-w
[Indexed for MEDLINE]

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