Journal Article
. 2008 Aug; 65(16):1552-5.
doi: 10.2146/ajhp070489.

Low-dose filgrastim in patients with breast cancer treated with docetaxel, doxorubicin, and cyclophosphamide

Eric J Ip 1 Annette Lee-Ma  Lawrence S Troxell  James Chan  
Affiliations
  • PMID: 18693211
  •     3 citations

Abstract

Purpose: The objective of this study was to compare low-dose filgrastim (150 microg/day subcutaneously) with standard-dose subcutaneous filgrastim (300 microg/day) or lenograstim (263 microg/day) in preventing febrile neutropenia and hospitalizations in breast cancer patients receiving the docetaxel-doxorubicin-cyclophosphamide regimen.

Methods: A single-center retrospective data analysis was performed involving 22 adult women with breast cancer who concurrently received the docetaxel-doxorubicin-cyclophosphamide chemotherapy regimen and low-dose filgrastim from March 2004 to February 2007. Data from this study were compared to previously published data in which patients received standard-dose filgrastim or lenograstim.

Results: More patients developed febrile neutropenia in the low-dose filgrastim group compared with the standard-dose group (32% versus 7.5%, respectively; p = 0.0014; relative risk [RR] = 4.24; 95% confidence interval [CI], 2.04-7.83). More patients were hospitalized due to febrile neutropenia in the low-dose filgrastim group compared with the standard-dose group (32% versus 6.5%, respectively; p < 0.001; RR = 4.89; 95% CI, 2.32-9.13). More chemotherapy cycles resulted in febrile neutropenia in the low-dose filgrastim group compared with the standard-dose group (6.7% versus 1.2%, respectively; p < 0.001; RR = 5.58; 95% CI, 2.49-12.27).

Conclusion: In patients with breast cancer treated with the docetaxel-doxorubicin-cyclophosphamide regimen, low-dose filgrastim was associated with a higher frequency of febrile neutropenia, hospitalization due to febrile neutropenia, and cycles with febrile neutropenia compared with a historical control group treated with standard-dose filgrastim or lenograstim.

Prophylaxis of chemotherapy-induced febrile neutropenia with granulocyte colony-stimulating factors: where are we now?
Matti Aapro, Jeffrey Crawford, Didier Kamioner.
Support Care Cancer, 2010 Mar 02; 18(5). PMID: 20191292    Free PMC article.
A way forward on the medically appropriate use of white cell growth factors.
Thomas J Smith, Bruce E Hillner.
J Clin Oncol, 2012 Mar 01; 30(14). PMID: 22370327    Free PMC article.
Review.
Impact of recommended weight-based dosing of granulocyte-colony stimulating factors in acute leukemia and stem cell transplant patients.
Jennifer K Hockings, Diwura K Owolabi, Joyce E Broyles, Susan C Wheelis.
Support Care Cancer, 2017 Jan 26; 25(6). PMID: 28120115