Low Dose rhG-CSF for Prophylaxis of Chemotherapy Induced Neutropenia in Non-Hodgkin's Lymphoma

Abstract

Abstract:

Background:  In the treatment of non-Hodgkin's lymphoma, the use of standard dose granulocyte-colony stimulating factors (rhG-CSF) at 5 μg/kg/day for chemotherapy induced neutropenia has shown strong evidence of clinical benefits. However, the efficacy of low-dose rhG-CSF in non-Hodgkin's lymphoma patients undergoing standard CHOP chemotherapy has not been evaluated. Method: This was a randomized, prospective trial of low dose granulocyte-colony stimulating factor (lenograstim at 50 μg, 100 μg) in intermediate-grade non-Hodgkin's lymphoma patients with severe
chemotherapy-induced neutropenia. Patients were evaluated for efficacy of low-dose therapy on the prevention and recovery from neutropenia. Results: Patients were randomized to receive 50 μg of rhG-CSF (12 patients) and 100 μg of rhG-CSF (16 patients). The two groups had similar backgrounds. The nadir neutrophil counts were significantly higher (p < 0.05) compared to observation period without rhG-CSF for both groups. The duration of neutropenic days was also significantly reduced by 43% for the 50 μg and 100 μg groups. Conclusion: Low dose rhG-CSF is very effective
in improving chemotherapy-induced neutropenia in intermediate-grade non-Hodgkin's lymphoma patients. This trial has shown that low dose therapy may deliver cost-effective therapy without compromising standard care.