Primary prophylaxis with G-CSF may improve outcomes in patients with newly diagnosed stage III/IV Hodgkin lymphoma treated with brentuximab vedotin plus chemotherapy.
We investigate the impact of granulocyte-colony stimulating factor (G-CSF) primary prophylaxis (G-PP, N = 83) versus no G-PP (N = 579) on safety and efficacy of brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A + AVD) in the ECHELON-1 study of previously untreated stage III/IV classical Hodgkin lymphoma. G-PP was associated with lower incidence of ≥ grade 3 neutropenia (29% versus 70%) and febrile neutropenia (11% versus 21%). Fewer dose delays (35% versus 49%), reductions (20% versus 26%), and hospitalizations (29% versus 38%) were observed. Seven neutropenia-associated deaths occurred in the A + AVD arm; none received G-PP. A + AVD with G-PP was associated with decreased risk of a modified progression-free survival event by 26% compared with A + AVD alone (95% CI: 0.40-1.37). G-PP reduced the rate and severity of adverse events, including febrile neutropenia, reduced treatment delays, dose reductions, and discontinuations, and may thus improve efficacy outcomes. These data support G-PP for all patients treated with A + AVD.
['Straus|David|D|', 'Collins|Graham|G|', 'Walewski|Jan|J|', 'Zinzani|Pier Luigi|PL|', 'Grigg|Andrew|A|', 'Sureda|Anna|A|', 'Illes|Arpad|A|', 'Kim|Tae Min|TM|', 'Alekseev|Sergey|S|', 'Specht|Lena|L|', 'Buccheri|Valeria|V|', 'Younes|Anas|A|', 'Connors|Joseph|J|', 'Forero-Torres|Andres|A|', 'Fenton|Keenan|K|', 'Gautam|Ashish|A|', 'Purevjal|Indra|I|', 'Liu|Rachael|R|0000-0001-6033-4510', 'Gallamini|Andrea|A|']
D000971:Antineoplastic Combined Chemotherapy Protocols D000079963:Brentuximab Vedotin D016179:Granulocyte Colony-Stimulating Factor D006689:Hodgkin Disease D006801:Humans D014747:Vinblastine
primary prophylaxis Hodgkin lymphoma brentuximab vedotin frontline therapy growth factor