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Published on: February 15, 2019

Prophylactic PEG-rhG-CSF Reduces Febrile Neutropenia in Pediatric Hematological Malignancies Compared with Daily

Xiao Zhang1, Yang Fu1, Hongsheng Wang1

  • 1Department of Hematology, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai 201102, China.

Cancers
|July 28, 2026
PubMed

Insights

Prophylactic pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) significantly reduced febrile neutropenia (FN) incidence in pediatric cancer patients compared to daily short-acting rhG-CSF. Safety profiles were similar, though larger studies are needed.

Area of Science:

  • Pediatric Hematology/Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Febrile neutropenia (FN) is a serious complication in pediatric hematological malignancies treated with chemotherapy.
  • Current treatment often involves daily recombinant human granulocyte colony-stimulating factor (rhG-CSF).
  • Pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) offers a prolonged-acting alternative.

Purpose of the Study:

  • To compare the efficacy and safety of single-dose PEG-rhG-CSF versus daily short-acting rhG-CSF in preventing FN in pediatric patients.
  • To evaluate secondary endpoints including neutropenia duration, recovery time, and healthcare resource utilization.
  • To assess the safety profile of PEG-rhG-CSF in this patient population.

Main Methods:

  • A single-center, open-label, randomized controlled trial involving pediatric patients (<18 years) with leukemia or lymphoma.
  • Patients received either a single dose of PEG-rhG-CSF (100 μg/kg) or daily short-acting rhG-CSF (5 μg/kg/day) post-chemotherapy.
  • Primary endpoint was FN incidence; secondary endpoints included neutropenia duration, neutrophil recovery time, and adverse events.

Main Results:

  • PEG-rhG-CSF significantly reduced FN incidence (59.3%) compared to daily rhG-CSF (77.7%) (p=0.046).
  • Subgroup analysis showed significant FN reduction in non-Hodgkin lymphoma patients treated with PEG-rhG-CSF.
  • No significant differences were found in FN duration, time to neutrophil recovery, transfusions, hospital stay, or costs. Adverse events were similar and mild.

Conclusions:

  • Single-dose prophylactic PEG-rhG-CSF is effective in lowering FN incidence in pediatric hematological malignancy patients compared to daily rhG-CSF.
  • The safety profile of PEG-rhG-CSF appears comparable to daily rhG-CSF.
  • Larger studies are needed to confirm safety and efficacy, especially for detecting rare adverse events.

Keywords:
childefficacyhematological malignanciespegylated recombinant human granulocyte colony-stimulating factorsafety

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