Low Dose Filgrastim Enhance NeutrophilRecovery and Recrease Incidence ofFebrile Neutropenia Following CHOP Regimen in Non Hodgkin's Lymphoma Patient

บทคัดย่อ

Abstract:

Full dose CHOP (Cyclophosphamide, Doxorubicin, Vincristine and Prednisolone) therapy is
a  standard treatment for Non Hodgkin lymphoma (NHL) patient. Incidence of febrile neutropenia in
patient  with CHOP therapy is 17 % and increase in age > 65 year (28 %). Other risk factors associated
with  febrile neutropenia during CHOP are albumin < 3.5 mg/dl, absolute neutrophil count < 1,500 cell/
cu.mm,  hepatitis disease, and dose intensity > 80%. Primary prophylaxis with granulocyte colony
stimulating  factor (G-CSF) can reduce risk of febrile neutropenia. Objectives : We study the efficacy
of l owd oseF ilgrastim( Neutromax2 .5 μ g/kg/day)i nN HLp atienta fterf ulld oseC HOPt herapyt o
enhance n eutrophilr ecoverya ndd ecreasei ncidenceo ff ebrilen eutropenia. M ethods: T hirty-sixe pisodes
 of NHL patient whom treated with full dose CHOP (Cyclophosphamide 750 mg/m2, Doxorubicin
50 mg/m2, Vincristin 1.2 mg./m2, and  Prednisolone 100 mg/day x 5 days ) or R-CHOP (Rituximab 375
mg/m2+ CHOP) chemotherapy were studied prospectively. All were received low dose filgrastim ( 2.5
μg/kg/day) on day 5-10. The incidence of febrile neutropenia and neutrophil < 500 cell/cu.mm were
analyzed. Results : There is no febrile neutropenia event in 36 episodes of NHL patients  after CHOP
followed by filgrastim therapy. The incidence of neutrophil < 500 cell/cu.mm is 8.33% (3/36 episodes),
18% is high risk group (2/11 episodes), and 4% is low risk group (1/25 episodes). All  three patients
with neutrophil < 500 cell/cu.mm had no infection. Conclusions : Low dose filgrastim ( 2.5 μ g/kg/
day) can enhance neutrophil recovery and decrease incidence of febrile neutropenia following full dose
CHOP/R-CHOP regimens in NHL patient.