Primary prophylaxis with pegfilgrastim in patients with newly-diagnosed diffuse large B-cell lymphoma: propensity score and instrumental variable analyses

Leuk Lymphoma. 2020 Oct;61(10):2435-2441. doi: 10.1080/10428194.2020.1775207. Epub 2020 Jun 12.

Abstract

The clinical impact of pegfilgrastim in day-to-day practice remains unclear. This study evaluated the effectiveness of pegfilgrastim compared with daily filgrastim in patients with DLBCL who received the first-cycle of R-CHOP treatment by using a Japanese national inpatient database. Patient characteristics were adjusted by using propensity-score matching and stabilized inverse probability of treatment weighting (IPTW). In 1295 propensity-score-matched pairs, the incidence of febrile neutropenia was significantly lower in the pegfilgrastim group (risk difference 6.1%, 95% CI 4.1%-8.1%) than in the filgrastim group. In the pegfilgrastim group, the length of hospital stay and the total costs were also significantly reduced (percent reduction 34% [95% CI: 31%-37%], percent reduction 12% [95% CI: 9%-15%], respectively). The stabilized IPTW showed comparable results. In day-to-day practice, the simple mode of pegfilgrastim administration may be advantageous.

Keywords: Febrile neutropenia; Pegfilgrastim; filgrastim; malignant lymphoma; propensity-matched analysis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Filgrastim
  • Granulocyte Colony-Stimulating Factor
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy
  • Neutropenia*
  • Polyethylene Glycols
  • Propensity Score
  • Recombinant Proteins

Substances

  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • pegfilgrastim
  • Polyethylene Glycols
  • Filgrastim