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Research Article| Volume 112, ISSUE 3, P601-604, March 2009

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The safety and efficacy of day 1 versus day 2 administration of pegfilgrastim in patients receiving myelosuppressive chemotherapy for gynecologic malignancies

  • Jenny M. Whitworth
    Affiliations
    University of Alabama at Birmingham, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, 618 South 19th Street, Old Hillman Building 538, Birmingham, AL 35233, USA
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  • Kellie S. Matthews
    Affiliations
    University of Alabama at Birmingham, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, 618 South 19th Street, Old Hillman Building 538, Birmingham, AL 35233, USA
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  • Kimberly A. Shipman
    Affiliations
    University of Alabama at Birmingham, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, 618 South 19th Street, Old Hillman Building 538, Birmingham, AL 35233, USA
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  • T. Michael Numnum
    Affiliations
    University of Alabama at Birmingham, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, 618 South 19th Street, Old Hillman Building 538, Birmingham, AL 35233, USA
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  • James E. Kendrick
    Affiliations
    University of Alabama at Birmingham, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, 618 South 19th Street, Old Hillman Building 538, Birmingham, AL 35233, USA
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  • Larry C. Kilgore
    Affiliations
    University of Alabama at Birmingham, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, 618 South 19th Street, Old Hillman Building 538, Birmingham, AL 35233, USA
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  • J. Michael Straughn Jr.
    Correspondence
    Corresponding author.
    Affiliations
    University of Alabama at Birmingham, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, 618 South 19th Street, Old Hillman Building 538, Birmingham, AL 35233, USA
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DOI:https://doi.org/10.1016/j.ygyno.2008.10.025
The safety and efficacy of day 1 versus day 2 administration of pegfilgrastim in patients receiving myelosuppressive chemotherapy for gynecologic malignancies
Previous ArticleA prospective study of quality of life among women undergoing risk-reducing salpingo-oophorectomy versus gynecologic screening for ovarian cancer
Next ArticleBisphosphonate-induced osteonecrosis of the jaw (ONJ): Incidence and risk factors in patients with breast cancer and gynecological malignancies

      Abstract

      Objective

      Pegfilgrastim is indicated to decrease the incidence of febrile neutropenia in patients with gynecologic malignancies who are receiving myelosuppressive chemotherapy. We sought to compare the safety and efficacy of day 1 pegfilgrastim administration to day 2 administration in patients with gynecologic malignancies.

      Methods

      We retrospectively evaluated patients receiving both chemotherapy and pegfilgrastim from June 1, 2006 to August 31, 2007 for a gynecologic malignancy. Abstracted data included patient demographics, pathology, blood counts, toxicity, and chemotherapy. After administration of chemotherapy, all patients either received 6 mg of pegfilgrastim subcutaneously on day 1 or day 2.

      Results

      1226 administrations of pegfilgrastim in 230 patients were identified. 490 administrations of pegfilgrastim were given on day 1 compared to 736 on day 2. 70% of patients had ovarian cancer with a median age of 64 years (range 15–88). 79% of patients had stage III, IV, or recurrent disease and 67% were undergoing primary chemotherapy. The most common chemotherapy was docetaxel/carboplatin (53%) followed by paclitaxel/carboplatin (19%). The mean absolute neutrophil count (ANC) nadir was 4810/mm3 in the day 1 cohort compared to 4212/mm3 in the day 2 cohort (p=.004). The incidence of Grade 3/4 neutropenia was similar in both groups (4.9% in day 1 vs. 5.7% in day 2; p=.63). Grade 3/4 febrile neutropenia was uncommon in both cohorts (0 episodes vs. 3 episodes; p=.41). Treatment delays were similar in both cohorts (5.9% vs. 7.5%; p=.35). Dose modifications were also similar in both cohorts (2.8% vs. 5.3%; p=.06).

      Conclusion

      Day 1 administration of pegfilgrastim is as effective as day 2 administration in the prevention of neutropenia in patients with gynecologic malignancies. Treatment delays and dose modifications were not increased after day 1 administration of pegfilgrastim. Administering pegfilgrastim on day 1 appears to be safe, effective, and convenient in selected patients receiving myelopsuppressive chemotherapy for gynecologic malignancies.

      Keywords

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      Article info

      Publication history

      Received: July 24, 2008

      Identification

      DOI: https://doi.org/10.1016/j.ygyno.2008.10.025

      Copyright

      © 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.

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