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Granulocyte colony-stimulating factors used in clinical practice: PoloNord Registry-Based Cohort Italian Study

Abstract

Aims and background. Granulocyte colony-stimulating factors are widely used to reduce myelotoxicity of chemotherapy and to allow its regular administration. National and international guidelines regulate their use. The aim of the study was to evaluate the use of pegfilgrastim and filgrastim/lenograstim in clinical practice, adherence to ASCO and ESMO guidelines, chemotherapy-related complications and adverse reactions.
Materials and methods. Data from 645 consecutive patients and 3,150 chemotherapy administrations, receiving granulocyte colony-stimulating factors, as primary/secondary prophylaxis or therapeutic use, for the first time during a line of chemotherapy, were recorded from 08/2008 to 08/2011, in 10 Lombardy Italian cancer centers. Patients and chemotherapy administrations data were examined in a multiple logistic regression analysis model.
Results. Adherence to guidelines: primary prophylaxis, pegfilgrastim and filgrastim/ lenograstim 66%/47% (P = 0.002); secondary prophylaxis, 19.0%/26.8%; but 56.8%/ 53.6% including patients at high risk of febrile neutropenia with grade 3-4 neutropenia. Correct timing start (administration 24-72 h after chemotherapy): pegfilgrastim and filgrastim/lenograstim, 93.2%/61.5% (P >0.0001).
Conclusions. Results suggest the more correct administration of pegfilgrastim as primary prophylaxis and timing start, compared to filgrastim/lenograstim. In secondary prophylaxis, the use of granulocyte colony-stimulating factors is extended beyond guideline recommendations to support patients at high risk of febrile neutropenia and to guarantee dose intensity. These outcomes suggest both the need of educational activities and the development of predictive tools to better define high risk patients and the use of granulocyte colony-stimulating factors.

Tumori 2014; 100(5): 491 - 498

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.1700/1660.18158

Authors

Daniele Fagnani, Luciano Isa, Magda Franca Verga, Paola Nova, Clelia Casartelli, Virginio Filipazzi, Marco Danova, Gabriella Farina, Palma Pugliese, Sergio Fava, Alessandro Bertolini, Claudio Cimminiello, Patrizia Boracchi, Giuseppe Marano, Claudia Panzarino, on behalf of the POLONORD Group

Article History

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Authors

  • Fagnani, Daniele [PubMed] [Google Scholar]
    Oncology Department and Medical Department of Azienda Ospedaliera di Desio e Vimercate, Vimercate (MB)
  • Isa, Luciano [PubMed] [Google Scholar]
    Oncology Unit of Ospedale di Gorgonzola, Gorgonzola (MI)
  • Verga, Magda Franca [PubMed] [Google Scholar]
    Oncology Department and Medical Department of Azienda Ospedaliera di Desio e Vimercate, Vimercate (MB)
  • Nova, Paola [PubMed] [Google Scholar]
    Oncology Department and Medical Department of Azienda Ospedaliera di Desio e Vimercate, Vimercate (MB)
  • Casartelli, Clelia [PubMed] [Google Scholar]
    Oncology Unit of Ospedale Valduce, Como
  • Filipazzi, Virginio [PubMed] [Google Scholar]
    Oncology Unit of Ospedale Sacco, Milan
  • Danova, Marco [PubMed] [Google Scholar]
    Oncology Unit of IRCCS Policlinico S Matteo, Pavia
  • Farina, Gabriella [PubMed] [Google Scholar]
    Oncology Unit of Ospedale Fatebenefratelli & Oftalmico, Milan
  • Pugliese, Palma [PubMed] [Google Scholar]
    Oncology Unit of Ospedale S Anna, Como
  • Fava, Sergio [PubMed] [Google Scholar]
    Oncology Unit of Ospedale Civile di Legnano, Legnano (MI)
  • Bertolini, Alessandro [PubMed] [Google Scholar]
    Oncology Unit of Ospedale di Sondrio, Sondrio
  • Cimminiello, Claudio [PubMed] [Google Scholar]
    Oncology Department and Medical Department of Azienda Ospedaliera di Desio e Vimercate, Vimercate (MB)
  • Boracchi, Patrizia [PubMed] [Google Scholar]
    Unit of Medical Statistics & Biometry, Department of Clinical Sciences & Community Health, University of Milan, Milan, Italy
  • Marano, Giuseppe [PubMed] [Google Scholar]
    Unit of Medical Statistics & Biometry, Department of Clinical Sciences & Community Health, University of Milan, Milan, Italy
  • Panzarino, on behalf of the POLONORD Group, Claudia [PubMed] [Google Scholar]
    Oncology Department and Medical Department of Azienda Ospedaliera di Desio e Vimercate, Vimercate (MB)

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