Efficacy and cost of G-CSF derivatives for prophylaxis of febrile neutropenia in lymphoma and multiple myeloma patients underwent autologous hematopoietic stem cell transplantation

Hematology. 2021 Dec;26(1):950-955. doi: 10.1080/16078454.2021.2003071.

Abstract

Objectives: To compare the efficacies and costs between pegfilgrastim and filgrastim prophylaxis for FN post-ASCT for lymphoma and multiple myeloma patients.

Methods: 43 patients who received pegfilgrastim (6 mg) were compared to a retrospective cohort of 129 patients that had received filgrastim post-ASCT. Hematopoietic recovery time, FN incidence and treatment costs were assessed and compared.

Results: The mean time to absolute neutrophil count engraftment was 8.72 ± 2.38 days for the prospective pegfilgrastim group and 9.87 ± 3.13 days for the retrospective filgrastim group (P = 0.027). The incidence of FN was 18.60% and 50.39% in prospective pegfilgrastim and retrospective filgrastim groups, respectively (P = 0.000). The mean cost of filgrastim was $617.22 ± 37.87, compared with $525.78 for pegfilgrastim (P = 0.032).

Discussion: Convenience, effectiveness, and safety of prophylaxis for FN in the prospective pegfilgrastim group were significantly improved compared to the retrospective filgrastim group in ASCT patients.

Conclusion: Pegfilgrastim prophylaxis was more effective and convenient than filgrastim for FN prophylaxis in patients post-ASCT, especially for MM patients.

Keywords: Stem cell transplantation; febrile neutropenia; filgrastim; pegfilgrastim.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cost-Benefit Analysis
  • Febrile Neutropenia / economics
  • Febrile Neutropenia / prevention & control*
  • Female
  • Filgrastim / adverse effects
  • Filgrastim / economics
  • Filgrastim / therapeutic use*
  • Hematologic Agents / adverse effects
  • Hematologic Agents / economics
  • Hematologic Agents / therapeutic use*
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Hematopoietic Stem Cell Transplantation* / economics
  • Humans
  • Lymphoma / economics
  • Lymphoma / therapy*
  • Male
  • Middle Aged
  • Multiple Myeloma / economics
  • Multiple Myeloma / therapy*
  • Polyethylene Glycols / adverse effects
  • Polyethylene Glycols / economics
  • Polyethylene Glycols / therapeutic use*
  • Prospective Studies
  • Retrospective Studies
  • Transplantation, Autologous / adverse effects
  • Transplantation, Autologous / economics
  • Treatment Outcome
  • Young Adult

Substances

  • Hematologic Agents
  • pegfilgrastim
  • Polyethylene Glycols
  • Filgrastim