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Granulocyte colony-stimulating factors for febrile neutropenia prophylaxis following chemotherapy : systematic review and meta-analysis
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Cooper, K. (Katy), Ph. D., Madan, Jason, Whyte, Sophie, Stevenson, M. (Matt) and Akehurst, Ron L. (2011) Granulocyte colony-stimulating factors for febrile neutropenia prophylaxis following chemotherapy : systematic review and meta-analysis. BMC Cancer, Volume 11 (Number 1). Article:404. doi:10.1186/1471-2407-11-404
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WRAP_Madan_1471-2407-11-404.pdf - Published Version Available under License Creative Commons Attribution Non-commercial No Derivatives. Download (467Kb) | Preview |
Official URL: http://dx.doi.org/10.1186/1471-2407-11-404
Abstract
Background:
Febrile neutropenia (FN) occurs following myelosuppressive chemotherapy and is associated with morbidity, mortality, costs, and chemotherapy reductions and delays. Granulocyte colony-stimulating factors (G-CSFs) stimulate neutrophil production and may reduce FN incidence when given prophylactically following chemotherapy.
Methods:
A systematic review and meta-analysis assessed the effectiveness of G-CSFs (pegfilgrastim, filgrastim or lenograstim) in reducing FN incidence in adults undergoing chemotherapy for solid tumours or lymphoma. G-CSFs were compared with no primary G-CSF prophylaxis and with one another. Nine databases were searched in December 2009. Meta-analysis used a random effects model due to heterogeneity.
Results:
Twenty studies compared primary G-CSF prophylaxis with no primary G-CSF prophylaxis: five studies of pegfilgrastim; ten of filgrastim; and five of lenograstim. All three G-CSFs significantly reduced FN incidence, with relative risks of 0.30 (95% CI: 0.14 to 0.65) for pegfilgrastim, 0.57 (95% CI: 0.48 to 0.69) for filgrastim, and 0.62 (95% CI: 0.44 to 0.88) for lenograstim. Overall, the relative risk of FN for any primary G-CSF prophylaxis versus no primary G-CSF prophylaxis was 0.51 (95% CI: 0.41 to 0.62). In terms of comparisons between different G-CSFs, five studies compared pegfilgrastim with filgrastim. FN incidence was significantly lower for pegfilgrastim than filgrastim, with a relative risk of 0.66 (95% CI: 0.44 to 0.98).
Conclusions:
Primary prophylaxis with G-CSFs significantly reduces FN incidence in adults undergoing chemotherapy for solid tumours or lymphoma. Pegfilgrastim reduces FN incidence to a significantly greater extent than filgrastim.
| Item Type: | Journal Article | ||||
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| Subjects: | R Medicine > R Medicine (General) R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) R Medicine > RM Therapeutics. Pharmacology |
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| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Systematic reviews (Medical research), Meta-analysis, Filgrastim, Neutropenia -- Treatment, Medicine -- Research -- Evaluation | ||||
| Journal or Publication Title: | BMC Cancer | ||||
| Publisher: | BioMed Central Ltd. | ||||
| ISSN: | 1471-2407 | ||||
| Official Date: | 2011 | ||||
| Dates: |
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| Volume: | Volume 11 | ||||
| Number: | Number 1 | ||||
| Page Range: | Article:404 | ||||
| DOI: | 10.1186/1471-2407-11-404 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access | ||||
| Funder: | Amgen Inc. |
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