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Area of Science:

  • Oncology
  • Hematology

Background:

  • Granulocyte colony-stimulating factor (G-CSF) prophylaxis reduces chemotherapy-induced neutropenia and febrile neutropenia.
  • Daily filgrastim injections are the preferred G-CSF formulation for primary prophylaxis in the South Texas Veterans Health Care System.

Purpose of the Study:

  • To evaluate the effectiveness of daily filgrastim for primary prophylaxis of febrile neutropenia in at-risk cancer patients.
  • To assess treatment delays, dose modifications, hospitalizations, and infections associated with daily filgrastim use.

Main Methods:

  • Retrospective, single-center cohort study of 59 patients receiving daily filgrastim for primary prophylaxis.
  • Inclusion criteria: curative cancer diagnosis, chemotherapy regimen with intermediate-to-high risk of febrile neutropenia.
  • Primary outcome: incidence of neutropenia/febrile neutropenia leading to treatment delays.

Main Results:

  • 17% of patients experienced treatment delays due to neutropenia/febrile neutropenia.
  • 25% were hospitalized (median 5 days), 15% had infections, and 3% required chemotherapy dose reduction.
  • 15% required additional filgrastim doses, and 15% were switched to pegfilgrastim.

Conclusions:

  • Daily filgrastim use resulted in treatment delays for a notable percentage of patients.
  • Tracking postnadir absolute neutrophil counts is crucial for optimizing filgrastim dosing and preventing neutropenia-related complications.