Primary Prophylaxis with G-CSF May Improve Outcomes in Patients with Newly Diagnosed Stage III/IV Hodgkin Lymphoma Treated with Brentuximab Vedotin Plus Chemotherapy
Leukemia & lymphoma（2020）SCI 4区
Mem Sloan Kettering Canc Ctr | Churchill Hosp | Maria Sklodowska Curie Mem Inst & Oncol Ctr | Univ Bologna | Austin Hosp | Hosp Quiron Dexeus | Univ Debrecen | Seoul Natl Univ Hosp | Petrov Res Inst Oncol | Univ Copenhagen | Univ Sao Paulo | BC Canc Ctr Lymphoid Canc | Seattle Genet | Millennium Pharmaceut Inc | Antoine Lacassagne Canc Ctr
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.
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Key words
Hodgkin lymphoma,brentuximab vedotin,frontline therapy,growth factor,primary prophylaxis
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