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Neutrophil recovery in elderly breast cancer patients receiving adjuvant anthracycline-containing chemotherapy with pegfilgrastim support.

Author(s): Brugger W, Bacon P, Lawrinson S, Romieu G

Affiliation(s): Schwarzwald-Baar Clinic Villingen-Schwenningen, University of Freiburg, Germany. wolfram.brugger@sbk-vs.de

Publication date & source: 2009-12, Crit Rev Oncol Hematol., 72(3):265-9. Epub 2009 Oct 23.

Publication type: Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Shortening duration of chemotherapy-induced neutropenia may reduce risk of infection and aid subsequent chemotherapy delivery. Cycle 1 neutrophil recovery was evaluated in 59 elderly women with breast cancer receiving adjuvant FEC100 (5-fluorouracil 500 mg/m(2), epirubicin 100mg/m(2) and cyclophosphamide 500 mg/m(2)) and randomized to pegfilgrastim primary prophylaxis (PP) from cycle 1, or secondary prophylaxis (SP, i.e., subsequent to a neutropenic event [no G-CSF in cycle 1]). In cycle 1, grade 4 neutropenia occurred in 77% (PP; N=30) and 72% (SP; N=29). Duration of grade 3-4 neutropenia was shorter with pegfilgrastim than without. Mean absolute neutrophil count (ANC) recovered above 1.0 x 10(9)/L by day 9 (pegfilgrastim) versus days 16-18 (without). At last observation (> or =day 14+/-2), no PP patient had ANC <1.0 x 10(9)/L versus approximately 25% of those receiving no pegfilgrastim. In conclusion, cycle 1 pegfilgrastim improved recovery from severe neutropenia in elderly breast cancer patients receiving adjuvant FEC100.

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