Primary prophylaxis with G-CSF may improve outcomes in patients with newly diagnosed stage III/IV Hodgkin lymphoma treated with brentuximab vedotin plus chemotherapy.

2020-12-25

Straus, David

Collins, Graham

Walewski, Jan

Zinzani, Pier Luigi

Grigg, Andrew P

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

Hodgkin lymphoma

brentuximab vedotin

frontline therapy

growth factor

primary prophylaxis

Journal Article

0000-0001-6033-4510

10.1080/10428194.2020.1791846

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.

link

Leukemia & Lymphoma 2020; 61(12): 2931-2938

Leukemia & Lymphoma