Granulopoiesis-stimulating factors to prevent adverse effects in the treatment of malignant lymphoma

Prophylactic treatment with granulopoiesis-stimulating factor reduces the risk for neutropenia, febrile neutropenia and infections in patients undergoing conventional chemotherapy for malignant lymphoma, but does not improve overall survival or freedom from treatment failure.

A Cochrane review included 13 studies with a total of 2 607 subjects. Compared with no prophylaxis, both granulocyte-colony-stimulating factor (G-CSF) and granulocyte-macrophage-colony-stimulating factor (GM-CSF) did not improve overall survival (HR 0.97, 95% CI 0.87 to 1.09; 10 studies, n=2221) or freedom from treatment failure (FFTF) (HR 1.11, 95% CI 0.91 to 1.35; 5 studies, n=718). Prophylaxis significantly reduced the risk for severe neutropenia (RR 0.67, 95% CI 0.60 to 0.73; 7 studies, n=1013), febrile neutropenia (RR 0.74, 95% CI 0.62 to 0.89; 4 studies, n=360) and infection (RR 0.74, 95% CI 0.64 to 0.85; 9 studies, n=1292). There was no evidence that either G-CSF or GM-CSF reduced the number of patients requiring intravenous antibiotics (RR 0.82, 95%CI 0.57 to 1.18; 4 studies, n=359); lowered infection related mortality (RR 0.93, 95% CI 0.51 to 1.71; 10 studies, n=1835); or improved complete tumour response (RR 1.03, 95% CI 0.95 to 1.10; 11 studies, n=2368).One study evaluated quality of life parameters and found no differences between the treatment groups.

Ədəbiyyat

1. Bohlius J, Herbst C, Reiser M, Schwarzer G, Engert A. Granulopoiesis-stimulating factors to prevent adverse effects in the treatment of malignant lymphoma. Cochrane Database Syst Rev 2008;(4):CD003189.