Retrospective comparison of the effects of filgrastim and pegfilgrastim on the pace of engraftment in auto-SCT patients Journal Article

Authors: Mathew, S.; Adel, N.; Rice, R. D.; Panageas, K.; Duck, E. T.; Comenzo, R. L.; Kewalramani, T.; Nimer, S. D.
Article Title: Retrospective comparison of the effects of filgrastim and pegfilgrastim on the pace of engraftment in auto-SCT patients
Abstract: The high doses of chemotherapy used for the preparatory regimens before autologous blood or marrow stem cell transplantation leave patients at risk for neutropenic complications. The administration of filgrastim post transplant reduces the time to neutrophil recovery and therefore has become a standard practice at many institutions. In 2006, we implemented a practice change from filgrastim to pegfilgrastim. We present data on 164 consecutive patients (82 patients who received filgrastim compared with 82 patients who received pegfilgrastim) who received an auto-SCT between January 2006 and November 2007. Patients who received pegfilgrastim had faster engraftment (9.6 days compared with 10.9 days, P<0.0001), a lower incidence of febrile neutropenia (59%compared with 78%, P=0.015), as well as shorter hospital stay, fewer days of treatment with i.v. antibiotics (6.3 days compared with 9.6 days, P=0.006), and fewer radiographic tests, which translated to an estimated total cost savings of over $8000 per patient. Overall, there were no differences in toxicity with these two agents. We conclude that a single dose of pegfilgrastim is a safe and efficacious alternative to daily injections of filgrastim and can be a cost-effective approach in auto-SCT patients. © 2010 Macmillan Publishers Limited All rights reserved.
Keywords: adult; controlled study; aged; middle aged; retrospective studies; young adult; major clinical study; neutropenia; dose response; drug efficacy; drug safety; treatment duration; cohort studies; incidence; drug dosage form comparison; autologous stem cell transplantation; bone pain; stem cell transplantation; retrospective study; febrile neutropenia; fever; cost control; cost effectiveness analysis; length of stay; anti-bacterial agents; engraftment; hematologic neoplasms; single drug dose; recombinant granulocyte colony stimulating factor; health care costs; transplantation, autologous; infection risk; filgrastim; leukopoiesis; auto-sct; pegfilgrastim; engraftment syndrome; hematologic agents
Journal Title: Bone Marrow Transplantation
Volume: 45
Issue: 10
ISSN: 0268-3369
Publisher: Nature Publishing Group  
Date Published: 2010-10-01
Start Page: 1522
End Page: 1527
Language: English
DOI: 10.1038/bmt.2009.373
PUBMED: 20062102
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 3" - "Export Date: 20 April 2011" - "CODEN: BMTRE" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Raymond L Comenzo
    112 Comenzo
  2. Stephen D Nimer
    344 Nimer
  3. Katherine S Panageas
    327 Panageas
  4. Nelly G Adel
    41 Adel
  5. Robert D Rice
    27 Rice
  6. Sherry Mathew
    11 Mathew
  7. Elaine Duck
    8 Duck