The effect of primary granulocyte-colony stimulating factor prophylaxis on incidence of febrile neutropenia in patients with testicular germ cell tumors.

e17056 Background: Testicular germ cell tumors (GCTs) represent only one percent of all solid tumors; however, they are the most common solid malignancy in men 15-35 years old. Febrile neutropenia (FN) is a grievous complication of chemotherapy, frequently occurring in GCT patients. The aim of this retrospective study was to assess the effect of primary granulocyte-colony stimulating factor (G-CSF) prophylaxis on the incidence of FN in GCT patients. Methods: This study was conducted using the National Cancer Institute medical records database. Patients diagnosed with germ cell tumors treated with first line/adjuvant chemotherapy at the National Cancer Institute, Bratislava, Slovakia from January 2000 to December 2017 were eligible. Starting in January 2006, patients received G-CSF prophylaxis after every cycle of chemotherapy. Results: Out of 393 patients, 265 patients received primary G-CSF prophylaxis and 128 patients did not receive prophylaxis. The majority of patients (69.97%) were treated with bleomycin, etoposide and cisplatin chemotherapy. There were 61 deaths (15.5%) in our study population. 2- and 5-year OS of the study group was 86.8% and 83.1%, respectively. During the study period, 71 patients (18.1%) suffered FN events. Out of 128 patients who did not receive primary prophylaxis, 42 (32.8%) patients suffered FN, while only 29 (10.9%) patients with primary prophylaxis suffered FN ( P = 0.0000001). On subgroup analysis, FN incidence decreased in all groups with primary prophylaxis, except for patients with stage I GCT receiving adjuvant chemotherapy. Patients receiving G-CSF prophylaxis had significantly longer overall survival when compared to patients without prophylaxis. (HR = 0.44, 95% CI 0.26-0.75; P = 0.0009). Conclusions: Primary G-CSF prophylaxis was associated with significantly decreased FN incidence and longer overall survival in patients treated with first line chemotherapy and should be consider in all patients except stage I disease.

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The effect of primary granulocyte-colony stimulating factor prophylaxis on the incidence of febrile neutropenia in patients with testicular germ cell tumors

10.21203/rs.3.rs-46060/v1 ◽

2020 ◽

Author(s):

Nikola Hapakova ◽

Michal Chovanec ◽

Katarina Rejlekova ◽

Katarina Kalavska ◽

Jana Obertova ◽

...

Keyword(s):

Overall Survival ◽

Germ Cell Tumors ◽

Primary Prophylaxis ◽

Testicular Germ Cell Tumors ◽

Granulocyte Colony Stimulating Factor ◽

Colony Stimulating Factor ◽

First Line ◽

Testicular Germ Cell ◽

Stimulating Factor ◽

Line Chemotherapy

Abstract Background: Testicular germ cell tumors (GCTs) are the most common solid malignancy in men 15-35 years old. Febrile neutropenia (FN) is a grievous complication of chemotherapy, frequently occurring in GCT patients. The aim of this retrospective study was to assess the effect of primary granulocyte-colony stimulating factor (G-CSF) prophylaxis on the incidence of FN in GCT patients. Patients and methods: This study was conducted from medical records database of GCTs patients treated with first line/adjuvant chemotherapy from January 2000 to December 2017. Starting in January 2006, patients received G-CSF prophylaxis after every cycle of chemotherapy. Results: Out of 393 patients, 265 patients received primary G-CSF prophylaxis and 128 patients did not receive prophylaxis. During the study period, 71 patients (18.1%) suffered FN events. Out of 128 patients who did not receive primary prophylaxis, 42 patients suffered FN, while only 29 patients with primary prophylaxis suffered FN (32.8% vs 10.9%, P = 0.0000001). On subgroup analysis, FN incidence decreased in all groups with primary prophylaxis, except for patients with stage I GCT receiving adjuvant chemotherapy. Patients receiving G-CSF prophylaxis had significantly longer overall survival when compared to patients without prophylaxis. (HR = 0.44, 95% CI 0.26-0.75; P = 0.0009).Conclusions: Primary G-CSF prophylaxis was associated with significantly decreased FN incidence in patients treated with first line chemotherapy for metastatic disease. Patients receiving G-CSF prophylaxis had significantly longer overall survival. We suggest, that primary G-CSF prophylaxis should be considered in GCT patients receiving first line chemotherapy.

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The effect of primary granulocyte-colony stimulating factor prophylaxis on the incidence of febrile neutropenia in patients with testicular germ cell tumors

10.21203/rs.3.rs-46060/v2 ◽

2020 ◽

Author(s):

Nikola Hapakova ◽

Michal Chovanec ◽

Katarina Rejlekova ◽

Katarina Kalavska ◽

Jana Obertova ◽

...

Keyword(s):

Overall Survival ◽

Germ Cell Tumors ◽

Primary Prophylaxis ◽

Testicular Germ Cell Tumors ◽

Granulocyte Colony Stimulating Factor ◽

Colony Stimulating Factor ◽

First Line ◽

Testicular Germ Cell ◽

Stimulating Factor ◽

Line Chemotherapy

Abstract Background: Testicular germ cell tumors (GCTs) are the most common solid malignancy in men 15-35 years old. Febrile neutropenia (FN) is a serious complication of chemotherapy, frequently occurring in GCT patients. The aim of this retrospective study was to assess the effect of primary granulocyte-colony stimulating factor (G-CSF) prophylaxis on the incidence of FN in GCT patients. Methods: This study was conducted from medical records database of GCTs patients treated with first line/adjuvant chemotherapy from January 2000 to December 2017. Starting in January 2006, patients received G-CSF prophylaxis after every cycle of chemotherapy. Results: Out of 385 patients, 264 patients received primary G-CSF prophylaxis and 121 patients did not receive prophylaxis. During the study period, 71 patients (18.4%) suffered FN events. Out of 121 patients who did not receive primary prophylaxis, 42 patients suffered FN, while only 29 patients with primary prophylaxis suffered FN (34.7% vs 11.0%, P = 0.00000003). On subgroup analysis, FN incidence decreased in all groups with primary prophylaxis, except for patients with stage I GCT receiving adjuvant chemotherapy. Patients receiving G-CSF prophylaxis had significantly longer overall survival when compared to patients without prophylaxis. (HR = 0.54, 95% CI 0.31-0.96; P = 0.0235).Conclusions: Primary G-CSF prophylaxis was associated with significantly decreased FN incidence in patients treated with first line chemotherapy for metastatic disease. Patients receiving G-CSF prophylaxis had significantly longer overall survival. We suggest, that primary G-CSF prophylaxis should be considered in GCT patients receiving first line chemotherapy.

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Incorporation of TIP (paclitaxel, ifosfamide, cisplatin) into first-line therapy for intermediate to poor risk testicular germ cell tumors with unfavorable marker decline after initial two cycles chemotherapy: A report of three cases

International Journal of Urology ◽

10.1111/j.1442-2042.2007.01755.x ◽

2007 ◽

Vol 14 (5) ◽

pp. 455-457 ◽

Cited By ~ 2

Author(s):

Jun-Ichiro Ishioka ◽

Yukio Kageyama ◽

Nobutaka Ichiyanagi ◽

Hiroshi Fukuda ◽

Yotsuo Higashi

Keyword(s):

Germ Cell ◽

Germ Cell Tumors ◽

Testicular Germ Cell Tumors ◽

First Line ◽

Testicular Germ Cell ◽

Poor Risk ◽

First Line Therapy ◽

Line Therapy

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Impact of Granulocyte-colony Stimulating Factor on Bleomycin-induced Pneumonitis in Chemotherapy-treated Germ Cell Tumors

Clinical Genitourinary Cancer ◽

10.1016/j.clgc.2017.08.012 ◽

2018 ◽

Vol 16 (1) ◽

pp. e193-e199 ◽

Cited By ~ 2

Author(s):

Edmond M. Kwan ◽

Sophie Beck ◽

Eitan Amir ◽

Michael A. Jewett ◽

Jeremy F. Sturgeon ◽

...

Keyword(s):

Germ Cell ◽

Germ Cell Tumors ◽

Granulocyte Colony Stimulating Factor ◽

Colony Stimulating Factor ◽

Stimulating Factor

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Analysis of the Safety of Pegfilgrastim Addition in Bleomycin, Etoposide, and Cisplatin Treatment Patients With Germ Cell Tumors

Frontiers in Oncology ◽

10.3389/fonc.2021.770067 ◽

2022 ◽

Vol 11 ◽

Author(s):

Ryunosuke Nakagawa ◽

Hiroaki Iwamoto ◽

Tomoyuki Makino ◽

Suguru Kadomoto ◽

Hiroshi Yaegashi ◽

...

Keyword(s):

Retrospective Study ◽

Germ Cell ◽

Germ Cell Tumors ◽

Granulocyte Colony Stimulating Factor ◽

Colony Stimulating Factor ◽

Single Center ◽

Chemotherapy Drugs ◽

Significant Difference ◽

Grade 3 ◽

Stimulating Factor

It has been reported that chemotherapy drugs and granulocyte colony-stimulating factor (G-CSF) administered on the same day can aggravate neutropenia. In the present study, we investigated the safety of pegfilgrastim during bleomycin, etoposide, and cisplatin (BEP) therapy. This single-center retrospective study, including 137 cycles of BEP therapy for germ cell tumors between January 2008 and April 2021, investigated safety. Short-acting G-CSF was used for 84 cycles and pegfilgrastim was used for 53 cycles. In the pegfilgrastim group, neutrophil count at nadir was significantly higher than in the G-CSF group (median 1,650/μl and 680/μl, respectively). The incidence of grade 3–4 neutropenia was significantly higher and the duration longer in the G-CSF group. Also, there was no significant difference in the incidence of febrile neutropenia. In conclusion, concomitant use of pegfilgrastim during BEP therapy did not increase neutropenia and was effective in terms of safety.

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