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Reduced dose pegfilgrastim is associated with less bone pain without increased neutropenia: a retrospective study.

Abstract：

BACKGROUND:Chemotherapy for breast cancer is associated with a high risk of neutropenia. Pegfilgrastim reduces the risk of neutropenic fever but commonly causes bone pain. OBJECTIVE:Evaluate whether a reduced dose of pegfilgrastim (3 mg) reduced the frequency of bone pain without compromising efficacy. METHODS:Records reviewed from breast cancer patients who received at least one 3 mg dose of pegfilgrastim, white blood count (WBC), and absolute granulocyte counts (AGC) were collected. Musculoskeletal pain scale was collected at each visit. RESULTS:265 treatments from 36 women were analyzed. There was no difference in post-treatment AGC between 3 versus 6 mg. Leukocytosis (WBC > 20,000 cells/cu mm) was more likely for those treated with 6 mg (chi-square 5.265, p = 0.0215). There was higher change in bone pain in patients who received 6 mg doses compared to none or 3 mg. LIMITATIONS:In this retrospective, non-randomized study, we found the majority of patients received the reduced 3 mg dose after intolerance to the 6 mg dose. It is unknown if smaller or larger doses than 3 mg would achieve similar results or whether 3 mg dose would be effective as an initial therapy or for patients receiving different chemotherapy regimens. Pain is observed despite premedication with naproxen and/or loratidine. CONCLUSION:Reduced dose of pegfilgrastim 3 mg was less likely to cause bone pain. The reduced dose was not associated with a significant difference in post-treatment AGC or rate of serious infection.

journal_name

Cancer Chemother Pharmacol

journal_title

Cancer chemotherapy and pharmacology

authors

Lower EE,Charif M,Bartelt M

doi

10.1007/s00280-018-3607-7

subject

Has Abstract

pub_date

2018-07-01 00:00:00

pages

165-170

issue

1

eissn

0344-5704

issn

1432-0843

pii

10.1007/s00280-018-3607-7

journal_volume

82

pub_type

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