Prophylaxis of chemotherapy-induced neutropenia and febrile neutropenia with lipegfilgrastim in patients with non-Hodgkin lymphoma (NADIR study)

Eur J Haematol. 2019 Feb;102(2):174-181. doi: 10.1111/ejh.13189. Epub 2018 Nov 23.

Abstract

Objective: The prospective non-interventional study (NIS) NADIR was designed to evaluate both effectiveness and safety of prophylactic use of lipegfilgrastim (Lonquex® ), a glycopegylated granulocyte colony-stimulating factor, in cancer patients with different tumor entities undergoing chemotherapy in routine clinical practice. The primary objective was incidence of severe neutropenia, febrile neutropenia (FN), and neutropenia-associated complications.

Method: NADIR was a national, multicenter, prospective NIS.

Results: Here, we present the data on patients with non-Hodgkin lymphoma (NHL). Final analysis comprised 337 NHL patients having received ≥1 administration of lipegfilgrastim. Primary prophylaxis with lipegfilgrastim was documented in 78.7% of patients with high risk to develop FN. In total, ≥1 severe neutropenia (grade 3/4) was reported in 115 (34.1%) patients and ≥1 event of FN documented in 15 (4.5%) patients. Grade 3/4 infections were reported in 22 (6.5%) patients overall. Most frequently reported adverse events (AEs) related to lipegfilgrastim in total were bone pain (5.4%), leukocytosis (2.1%), back pain (1.8%), platelet count decreased (1.2%), and myalgia (1.2%). Fatal serious AEs were documented in 9 (2.7%) patients; none were attributable to lipegfilgrastim.

Conclusion: Prophylaxis or therapeutic intention with lipegfilgrastim in NHL patients in routine clinical practice showed similar effectiveness and safety as demonstrated in the pivotal trials.

Keywords: chemotherapy-induced febrile neutropenia; granulocyte colony-stimulating factor; lipegfilgrastim; non-Hodgkin lymphoma; primary prophylaxis; routine clinical practice.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Chemotherapy-Induced Febrile Neutropenia / diagnosis
  • Chemotherapy-Induced Febrile Neutropenia / prevention & control*
  • Comorbidity
  • Febrile Neutropenia / diagnosis
  • Febrile Neutropenia / etiology*
  • Febrile Neutropenia / prevention & control*
  • Female
  • Filgrastim / administration & dosage
  • Filgrastim / therapeutic use*
  • Humans
  • Incidence
  • Lymphoma, Non-Hodgkin / complications*
  • Lymphoma, Non-Hodgkin / diagnosis
  • Lymphoma, Non-Hodgkin / drug therapy
  • Male
  • Middle Aged
  • Polyethylene Glycols / administration & dosage
  • Polyethylene Glycols / therapeutic use*
  • Prospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • pegfilgrastim
  • Polyethylene Glycols
  • Filgrastim

Grants and funding