scholarly journals Meta-Analysis of Chemotherapy-Induced (Febrile) Neutropenia and Chemotherapy Disruptions Associated with Same-Day Versus Standard (24-72h) Pegfilgrastim Administration in Non-Hodgkin Lymphoma Patients

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3011-3011
Author(s):  
Neda Alrawashdh ◽  
Ali McBride ◽  
Ivo Abraham
Keyword(s):  
Febrile Neutropenia ◽  
Hodgkin Lymphoma ◽  
Time Window ◽  
Meta Analysis ◽  
Fixed Effect Model ◽  
Independent Study ◽  
Standard Regimen ◽  
Non Hodgkin Lymphoma ◽  
Retrospective Cohort Studies ◽  
Chemotherapy Dose

Abstract Background: While the product label and international guidelines recommend pegfilgrastim administration 24-72 hours following completion of chemotherapy, increasingly clinicians administer pegfilgrastim using a same-day protocol. We performed a meta-analysis to compare the incidence of febrile neutropenia (FN), chemotherapy-induced neutropenia (CIN) grade 4, and CIN/FN-related chemotherapy delays and dose reductions in non-Hodgkin lymphoma (NHL) patients treated with cyclophosphamide, doxorubicin, vincristine, and prednisone with or without rituximab (R±CHOP) who were provided with pegfilgrastim on the same-day of chemotherapy versus the standard 24-72h post-chemotherapy time window. Methods: Six databases were searched for studies that compared same-day pegfilgrastim with the standard regimen in NHL patients. Given the low heterogeneity (I 2<50%, Cochrane Q test P>0.10, fixed-effect model was used to estimate pooled odds ratios (ORs) and 95% confidence intervals (CIs) for all outcomes of interest. Results: We identified 7 studies, including one clinical trial (Burris et al. 2010) and six retrospective cohort studies (Woods et al. 2010, Ibrahim et al. 2011, Karol et al. 2013, Cheng et al. 2014, Bartels et al. 2021, McBride et al. 2021), that evaluated same-day versus standard 24-72h administration of pegfilgrastim in NHL patients. Results were statistically non-significant for all outcomes (Figure 1): FN across all chemotherapy cycles (OR=1.48, 95%CI= 0.98-2.23, P=0.06, N of studies=7); FN after the first cycle (OR=1.98, 95% CI=0.80-4.90, P=0.14, N=4); CIN grade 4 across all cycles (OR=0.73, 95% CI=0.37-1.47, P= 0.38, N=3); CIN grade 4 after the first cycle (OR=2.58, 95%CI= 0.86-7.73, P=0.09, N=3); and chemotherapy dose delays or reductions (OR=2.25, 95%CI=0.42-11.97, P= 0.34, N=2). Conclusion: In this independent study, the likelihood of developing FN and CIN grade 4 in the first cycle or across all chemotherapy cycles, and the likelihood of chemotherapy dose delays or reductions were statistically not different in NHL patients treated with R±CHOP and administered pegfilgrastim same-day or 24-72h post-chemotherapy. In the setting of NHL treated with R±CHOP, administering pegfilgrastim on the day of completion of chemotherapy may be a safe and effective method of prophylaxis. Figure 1 Figure 1. Disclosures Alrawashdh: Genentech: Current Employment. McBride: BMS: Current Employment. Abraham: Matrix45, LLC: Current holder of individual stocks in a privately-held company.

Food of animal origin and risk of non-Hodgkin lymphoma and multiple myeloma: A review of the literature and meta-analysis

2016 ◽  
Vol 100 ◽  
pp. 16-24 ◽  
Author(s):  
Saverio Caini ◽  
Giovanna Masala ◽  
Patrizia Gnagnarella ◽  
Ilaria Ermini ◽  
William Russell-Edu ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Hodgkin Lymphoma ◽  
Meta Analysis ◽  
Animal Origin ◽  
Review Of The Literature ◽  
Non Hodgkin Lymphoma ◽  
Food Of Animal Origin

Thrombotic complications in adult patients with lymphoma: a meta-analysis of 29 independent cohorts including 18 018 patients and 1149 events

Blood ◽  
2010 ◽  
Vol 115 (26) ◽  
pp. 5322-5328 ◽  
Author(s):  
Vanesa Caruso ◽  
Augusto Di Castelnuovo ◽  
Susana Meschengieser ◽  
Maria A. Lazzari ◽  
Giovanni de Gaetano ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Meta Analysis ◽  
Hematologic Malignancies ◽  
Incidence Rates ◽  
Clinical Implications ◽  
Low Grade ◽  
Thrombotic Risk ◽  
Non Hodgkin Lymphoma ◽  
Thrombotic Complications ◽  
Exact Maximum Likelihood

AbstractThrombotic complications in hematologic malignancies have important clinical implications. In this meta-analysis we sought to obtain accurate estimates of the thrombotic risk in lymphoma patients. Articles were searched in electronic databases and references. Eighteen articles were identified (29 cohorts, 18 018 patients and 1149 events). Pooled incidence rates (IRs) were calculated by the use of a method based on the exact maximum likelihood binomial distribution. The global IR of thrombosis was 6.4% (95% confidence interval [CI] 6.0%-6.8%). The global IRs of venous or arterial events were 5.3% (95% CI, 5.0%-5.7%) and 1.1% (95% CI, 0.9%-1.2%), respectively. The IR of thrombosis observed in subjects with non-Hodgkin lymphoma (NHL) was 6.5% (95% CI, 6.1%-6.9%), significantly greater than that observed for patients with Hodgkin lymphoma (4.7%; 95% CI, 3.9%-5.6%). Within NHL, patients with high-grade disease had a greater risk of events (IR 8.3%; 95% CI, 7.0%-9.9%) than low-grade disease (IR 6.3%; 95% CI, 4.5%-8.9%). This meta-analysis shows that the IR of thrombosis in lymphoma patients is quite high, especially in those with NHL at an advanced stage of the disease. These results may help better defining lymphoma populations at high thrombotic risk, to whom prophylactic approaches could be preferentially applied.

Hepatitis B virus and risk of non-Hodgkin lymphoma: An updated meta-analysis of 58 studies

2018 ◽  
Vol 25 (8) ◽  
pp. 894-903 ◽  
Author(s):  
M. Li ◽  
Y. Gan ◽  
C. Fan ◽  
H. Yuan ◽  
X. Zhang ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Hodgkin Lymphoma ◽  
Meta Analysis ◽  
Non Hodgkin Lymphoma ◽  
B Virus

scholarly journals A Randomized Controlled Clinical Study of Peg-Rhg-CSF for Preventing Chemotherapy-Induced Neutropenia in Patients with B-Cell Non-Hodgkin Lymphoma

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 5323-5323
Author(s):  
Changqing Zhen ◽  
Mei Ding ◽  
Kang Lu ◽  
Xueling Ge ◽  
Na Chen ◽  
...  
Keyword(s):  
Clinical Study ◽  
Febrile Neutropenia ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Cell Lymphoma ◽  
Study Group ◽  
Randomized Controlled ◽  
Non Hodgkin Lymphoma ◽  
Prophylactic Use ◽  
Controlled Clinical Study

Introduction: B-cell non-Hodgkin lymphoma is the most frequent type of non-Hodgkin's lymphoma. RCHOP regimen is established as the standard therapy for aggressive and indolent B-cell NHL, which has a 10%-20% rate of febrile neutropenia (FN). Recently, pegylated recombinant human granulocyte colony stimulating factor (PEG-rhG-CSF) is frequently used in clinical practice. This randomized controlled clinical study was conducted to investigate the efficacy and safety of prophylactic PEG-rhG-CSF in patients with B-cell non-Hodgkin lymphoma on RCHOP chemotherapy. Methods:We included 162 patients with pathological diagnosis of B-cell non-Hodgkin lymphoma including diffuse large B-cell lymphoma, follicular lymphoma and mantle cell lymphoma (MCL),from October 2016 to May 2019 at Shandong Provincial Hospital Affiliated to Shandong University. All patients gave written informed consent in accordance with the Declaration of Helsinki. The patients were randomized into PEG-rhG-CSF and rhG-CSF groups. Each patient received three cycles of chemotherapy with identical RCHOP regimens. In the study group, the patients received PEG-rhG-CSF 6mg(weight≥45Kg)or 3mg(weight≤45Kg)once 24 hours after the end of chemotherapy drugs of every chemotherapy cycle. In the control group, they weren't preventively administered rhG-CSF. If their neutrophil count (ANC)≤1.0×109/L, they were administered rhG-CSF:5ug/kg/day until their neutrophil count (ANC)≥2.0×109/L. The primary endpoint was the incidence of III/IV grade neutropenia and febrile neutropenia(FN) after each chemotherapy cycle. Meanwhile the rate of antibiotics application and safety were observed. Analyses were performed with SPSS Statistics 20.0 (IBM-SPSS, Chicago, Illinois). The numerical data was presented as mean ± SD. Statistical analysis was performed using one-way analysis of variance and chi-square test. A p-value<0.05 was considered statistically significant. Results: Clinical characteristics for PEG-rhG-CSF and rhG-CSF groups were shown in Table1. There were no significant differences in age, gender,height, body weight, body mass index, Ann Arbor and IPI staging. The incidence of IV grade neutropenia during cycle 1 in 81 evaluable study cycles and 81 evaluable control cycles were 7.41% and 35.80%( P<0.01), with durations of 2.85±0.62 days and 3.11±1.23 days (P>0.05). The differences in I/II/III grade neutropenia between study and control groups weren't statistically significant (Table2,Fig.1). After secondary prophylactic use of PEG-rhG-CSF In the study group, the incidences of III/IV grade neutropenia decreased from 77.78% to 14.81% (P<0.01).Statistically significant differences were observed in the incidences of FN (12.35% and 34.57% for the PEG-rhG-CSF and rhG-CSF groups, respectively; P<0.01) and in the proportion of patients who received antibiotic therapy (11.11% and 37.04%, respectively; P<0.01) during cycle 1(Table2,Fig .2). The safety profiles of PEG-rhG-CSF and rhG-CSF were similar. Bone pain occurred in 7.41% of the cases during the study cycles and 2.47% in the control cycles (P>0.05 ), which were mostly mild or moderate. Patients receiving PEG-rhG-CSF who developed III/IV grade neutropenia were significantly older than those without neutropenia (53.41±14.96 vs. 63.64±4.65;years; p=0.01) (Fig.3).The incidence of III/IV grade neutropenia in patients older than 60 years was significantly higher than that in patients younger than 60 years(24.44% vs. 6.38%; P =0.038). Conclusions: Prophylactic use of PEG-rhG-CSF could effectively reduce the incidences of grade III/IV neutropenia and FN, which ensures that patients with lymphoma receive standard-dose chemotherapy to improve prognosis. III/IV grade neutropenia after prophylactic use of PEG-rhG-CSF were more likely to occur in patients older than 60 years. After the use of PEG-rhG-CSF, the elderly patients should be pay more attention to them. Disclosures No relevant conflicts of interest to declare.

Trends in use of primary prophylactic colony stimulating factors and neutropenia-related hospitalization in commercially insured patients receiving myelosuppressive chemotherapy in the United States: 2005–2017

2020 ◽  
pp. 107815522091577 ◽  
Author(s):  
Jennifer R Schenfeld ◽  
Corina W Bennett ◽  
Shuling Li ◽  
Lucy J DeCosta ◽  
Renee R Jaramillo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
High Risk ◽  
Febrile Neutropenia ◽  
Hodgkin Lymphoma ◽  
Colony Stimulating Factor ◽  
Myelosuppressive Chemotherapy ◽  
Colony Stimulating Factors ◽  
Non Hodgkin Lymphoma ◽  
Insured Patients ◽  
Stimulating Factor

Purpose Describe temporal changes in use of myelosuppressive chemotherapy, primary prophylactic colony-stimulating factor, and neutropenia-related hospitalization, in commercially insured patients. Methods Using a large commercial administrative database, we identified annual cohorts of adult patients diagnosed with breast or lung cancer, or non-Hodgkin lymphoma and initiating myelosuppressive chemotherapy during 2005–2017. We described yearly changes in proportions of myelosuppressive chemotherapy by febrile neutropenia risk category (high, intermediate, unclassified) and proportion of prophylactic colony-stimulating factor use and unadjusted incidence of neutropenia-related hospitalization in the first cycle of myelosuppressive chemotherapy. Results Annual cohorts included 4383–5888 eligible patients during 2005–2017. The proportion of eligible patients aged ≥ 65 years increased from 26.0% in 2005 to 58.2% in 2017. Myelosuppressive chemotherapy use with regimens with high risk for febrile neutropenia increased from 15.1% in 2005 to 31.0% in 2017; and regimens with intermediate risk for febrile neutropenia decreased from 63.7% to 48.1% in 2017. Prophylactic colony-stimulating factor use increased from 41.6% in 2005 to 54.3% in 2017. Crude incidence of neutropenia-related hospitalization for all cancers increased from 2.0% to 3.1%, with a substantial increase in neutropenia-related hospitalization observed among non-Hodgkin lymphoma patients (2.8% to 8.5%) during 2005–2017. Conclusion Among adult patients with breast and lung cancer, and non-Hodgkin lymphoma receiving myelosuppressive chemotherapy, use of regimens with high risk for febrile neutropenia increased, as did the use of prophylactic colony-stimulating factors after 2005. Incidence of neutropenia-related hospitalization increased slightly, particularly among non-Hodgkin lymphoma patients. Further studies are required to understand this increasing trend of neutropenia-related hospitalization, changing patient-level risk factors, and febrile neutropenia management.

Association between red blood cell transfusions and development of non-Hodgkin lymphoma: a meta-analysis of observational studies

Blood ◽  
2010 ◽  
Vol 116 (16) ◽  
pp. 2897-2907 ◽  
Author(s):  
Jorge J. Castillo ◽  
Samir Dalia ◽  
Sheila K. Pascual
Keyword(s):  
Cohort Studies ◽  
Hodgkin Lymphoma ◽  
Observational Studies ◽  
Meta Analysis ◽  
Case Control ◽  
Lymphocytic Leukemia ◽  
Blood Transfusions ◽  
Non Hodgkin Lymphoma ◽  
Newcastle Ottawa Scale ◽  
Trim And Fill

AbstractThe incidence of non-Hodgkin lymphoma (NHL) has increased steadily for the past few decades. Previous studies have suggested an association between blood transfusions and NHL. The main objective of this study was to evaluate this relationship with a meta-analysis of observational studies. A literature search was undertaken, looking for case-control and cohort studies evaluating the risk of developing NHL in persons who received allogeneic blood transfusions; 14 studies were included. Outcome was calculated and reported as relative risk (RR). Heterogeneity was assessed with Cochrane Q and I2 statistics. Dissemination bias was evaluated by funnel plot visualization and trim-and-fill analysis. Quality assessment was performed with the Newcastle-Ottawa scale. Our analysis showed a RR of developing NHL of 1.05 (95% CI, 0.89-1.25; P = .42) and 1.34 (95% CI, 1.15-1.55; P < .01) in case-control and cohort studies, respectively. When pooling all studies, RR was 1.2 (95% CI, 1.07-1.35; P < .01). In subset analysis, RR of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) was 1.66 (95% CI, 1.08-2.56; P = .02). The RR of NHL was elevated in both men and women and in persons receiving transfusions either before or after 1992. Blood transfusions appear to increase the risk of developing NHL; however, the risk of CLL/SLL appears higher than for other NHL subtypes.

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