1. Primary prophylaxis with G-CSF may improve outcomes in patients with newly diagnosed stage III/IV Hodgkin lymphoma treated with brentuximab vedotin plus chemotherapy
- Author
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Straus, David, Collins, Graham, Walewski, Jan, Zinzani, Pier Luigi, Grigg, Andrew, Sureda, Anna, Illes, Arpad, Kim, Tae Min, Alekseev, Sergey, Specht, Lena, Buccheri, Valeria, Younes, Anas, Connors, Joseph, Forero-Torres, Andres, Fenton, Keenan, Gautam, Ashish, Purevjal, Indra, Liu, Rachael, Gallamini, Andrea, Straus, David, Collins, Graham, Walewski, Jan, Zinzani, Pier Luigi, Grigg, Andrew, Sureda, Anna, Illes, Arpad, Kim, Tae Min, Alekseev, Sergey, Specht, Lena, Buccheri, Valeria, Younes, Anas, Connors, Joseph, Forero-Torres, Andres, Fenton, Keenan, Gautam, Ashish, Purevjal, Indra, Liu, Rachael, and Gallamini, Andrea
- Abstract
We investigate the impact of granulocyte-colony stimulating factor (G-CSF) primary prophylaxis (G-PP, N = 83) versus no G-PP (N = 579) on safety and efficacy of brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A + AVD) in the ECHELON-1 study of previously untreated stage III/IV classical Hodgkin lymphoma. G-PP was associated with lower incidence of ≥ grade 3 neutropenia (29% versus 70%) and febrile neutropenia (11% versus 21%). Fewer dose delays (35% versus 49%), reductions (20% versus 26%), and hospitalizations (29% versus 38%) were observed. Seven neutropenia-associated deaths occurred in the A + AVD arm; none received G-PP. A + AVD with G-PP was associated with decreased risk of a modified progression-free survival event by 26% compared with A + AVD alone (95% CI: 0.40–1.37). G-PP reduced the rate and severity of adverse events, including febrile neutropenia, reduced treatment delays, dose reductions, and discontinuations, and may thus improve efficacy outcomes. These data support G-PP for all patients treated with A + AVD.
- Published
- 2020