Secondary prophylactic C-CSF (filgrastim) administration in chemotherapy of stage I and II Hodgkin's lymphoma with ABVD

The purpose of this study was to determine the effect of granulocyte colony-stimulating factor (filgrastim. G-CSF) for maintenance of chemotherapy dose-intensity in patients with stage I or II Hodgkin`s lymphoma treated with six cycles of doxorubicin, bleomycin, vinblastine. and dacarbazine (ABVD). 7Fifty-six patients with stage I or II Hodgkin's lymphoma treated with ABVD were eligible For secondary prophylactic G-CSF administration because of neutropenia (absolute neutrophil count < 1 x 10(9)/L) causing treatment delay or febrile neutropenia. Patients received 300 mug (total dose) of G-CSF (filgrastim) subcutaneously on days 3 to 7 and 17 to 21 of each cycle in order to prevent dose reduction or delay in subsequent cycles of treatment continuing the G-CSF until completion of chemotherapy. Results showed that 30 (54%) of the patients required the use of G-CSF, 26 (47%) during the first or second cycle. After G-CSF administration delay in chemotherapy did not occur in 25 patients, whereas: delays in the Fifth or sixth cycle occurred in four patients, Despite treatment with G-CSF, one patient had febrile neutropenia. Dose intensity greater than 90% of that planned was delivered to more the 85% of patients. In conclusion: Secondary prophylactic G-CSF administration was necessary in more than half of patients with stage I or II Hodgkin's lymphoma during chemotherapy with 48VD. The use of G-CSF allowed maintenance of chemotherapy schedule and dose intensity in the majority of patients.