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Table 3 Incidence of grade 1–4 neutropenia

From: Prophylactic pegfilgrastim to prevent febrile neutropenia among patients receiving biweekly (Q2W) chemotherapy regimens: a systematic review of efficacy, effectiveness and safety

Study

Neutropenia

Balducci [19]

Neutropenia

Combined CHOP and R-CHOP Q2W

Combined CHOP and R-CHOP Q3W

<  65 years

65–75 years

>  75 years

Overall

<  65 years

65–75 years

>  75 years

Overall

Any grade, n (%)

0 (0)

1 (3.3)

–

1 (1.6)

0 (0)

5 (6.4)

1 (3.1)

6 (4.4)

Grade ≥ 3, n (%)

0 (0)

0 (0)

–

0 (0)

0 (0)

2 (2.6)

1 (3.1)

3 (2.2)

Donkor [21]

 

Pegfilgrastim < 14 days group (n = 126)

Pegfilgrastim > 14 days group (n = 25)

Filgrastim group (n = 90)

No CSF group (n = 295)

Incidence of neutropenia, n (%)

0 (0)

1 (4)

24 (26.7)

25 (8.5)

Dragnev [22]

 

Filgrastim (n = 25)

Pegfilgrastim (n = 10)

p value

WBC/ANC (any grade toxicity)

2

0

p = 1.0

Hecht [23]

 

Placebo (n = 118)

Pegfilgrastim (n = 123)

OR (95% CI)

p value

All combined, % (95% CI)

43 (34.3–52.1)

13 (7.2–18.9)

0.19 (0.10–0.37)

p < 0.001

FOLFOX-4, % (95% CI)

n = 58

n = 61

0.11 (0.04–0.36)

p < 0.001

37.9 (25.5–51.6)

6.6 (1.8–15.9)

FOLFIRI, % (95% CI)

n = 30

50.0 (31.3–68.7)

n = 32

15.6 (5.3–32.8)

0.19 (0.06–0.61)

p = 0.0061

FOIL, % (95% CI)

n = 30

46.7 (28.3–65.7)

n = 30

23.3 (9.9–42.3)

0.35 (0.11–1.05)

p < 0.1033

Kourlaba [25]

Severe neutropenia, % (95% CI)

Filgrastim

Pegfilgrastim

 

p value

32.3 (28.4–36.5)

10.4 (7.9–13.3)

 

p < 0.001

Kurbacher [26]

Grade 3/4 neutropenia, %

Pegfilgrastim (n = 27)

Lipegfilgrastim (n = 26)

  

5.6

3.5

Lane [27]

Duration of grade 4 neutropenia

Pegfilgrastim

G-CSF

p value

 

All cycles, days (95% CI)

4 (0–11)

4 (0–10)

0.55

 

A cycles, days (95% CI)

2 (0–7)

2 (0–6)

0.65

 

B cycles, days (95% CI)

6 (2–12)

6 (0–10)

0.70

 

Pinter [30]

Neutropenia grade

Pegfilgrastim, n (%)

Placebo, n (%)

Difference

OR (95% CI)

p value

Grade 3/4

15 (3.6)

72 (17)

−13.5% (−18.3, −8.7)

0.18 (0.1–0.32)

< 0.001

Grade 4

10 (2.4)

35 (8.3)

−5.9% (−9.6, −2.2)

0.27 (0.13–0.56)

< 0.001

Grade 3/4 in FOLFOX-treated patients

4 (1.9)

37 (17.9)

n/a

0.09 (0.03–0.26)

n/a

Grade 3/4 in FOLFIRI-treated patients

11 (5.1)

35 (16.2)

n/a

0.28 (0.14–0.57)

n/a

Grade 3/4 in low-dose patients

4 (2.5)

28 (16.1)

n/a

0.13 (0.05–0.39)

n/a

Grade 3/4 in high-dose patients

11 (4.2)

44 (17.7)

n/a

0.20 (0.10–0.41)

n/a

Skarlos [31]

 

Filgrastim

Pegfilgrastim

p value

  
 

Severe neutropenia, n (%)

34 (32)

41 (38)

p = 0.36

  
  1. ANC absolute neutrophil count, CHOP cyclophosphamide, doxorubicin, vincristine, and prednisone, CI confidence interval, CSF colony-stimulating factor, FOIL 5-fluorouracil, leucovorin, oxaliplatin, and irinotecan, FOLFIRI 5-fluorouracil, leucovorin, and irinotecan, FOLFOX 5-fluorouracil, leucovorin, and oxaliplatin, G-CSF granulocyte colony-stimulating factor, n/a not applicable, OR odds ratio, Q2W biweekly, Q3W every 3 weeks, R-CHOP rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone, WBC white blood cell
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BMC Cancer

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