Efficacy profile daily injection filgrastim in chemotherapy-induced (ct) febrile neutropenia (fn) in patients with acute leukemia (al): ukranian retrospective study in a real-life cohort

Abstract

Materials and methods: 59 primary patients with AL (median age: 53.8, range: 9.23 years; male 35 (59.3%), female 24 (40.7%); ECOG I-II) were included in the study during 2021-2023 and received the standard induction CT according to ESMO Clinical Practice Guidelines in our department. The patients were enrolled into two groups: 31(52.5%) and 28(47.5%) pts in control and study to Filgrastim groups, respectively. 21(35.6%) acute myeloid leukemia (AML) pts and 10(17%) acute lymphoblastic leukemia (ALL) pts were involved in IA and IIA control groups; 17(28.8%) AML-pts and 11(18.6%) ALL-pts were contained in IB and IIB study groups, respectively. Results. We verified Gr 4 neutropenia in 17(80.95%) pts of group IA and 14 (82.35%) pts of group IB which received regimen 7+3 with/without etoposide. Duration time of Gr 4 neutropenia in group IB versus group IA was 1.5 times less, t(38)= 3.65, р˂0.001. FN developed significantly rarer in IB group with G-CSFs, X2(1, N=38) = 4.87, p˂0.03. Among the patients with ALL was registered Gr 4 neutropenia in 6 (60%) pts of group IIA and 6 (54.5%) pts of group IIB. Duration time of FN was 2.7 times less in IIB group with G-CSFs than in group IIA, t(21)= 6.62, р˂0.00001. But there was no difference in the number of FN episodes developed in IIB vs IIA groups, p˃0.05. Conclusions. Filgrastim effectively prevents the development of FN in patients with AML against the background of severe cytostatic neutropenia. Thus, the use of Filgrastim made it possible to reduce the duration of severe neutropenia in patients with AL during induction CT.