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Abstract
Purpose
We conducted a retrospective study to evaluate the efficacy and related costs of using two different molecules of granulocyte-colony stimulating factor (G-CSF) (lenograstim – LENO or filgrastim – FIL) as primary prophylaxis of chemotherapy-induced neutropenia in a hematological inpatient setting.
Methods
The primary endpoints of the analysis were the efficacy of the two G-CSFs in terms of the level of white blood cells, hemoglobin and platelets at the end of the treatment and the per capita direct medical costs related to G-CSF prophylaxis.
Results
Two hundred twelve patients (96 LENO, 116 FIL) have been evaluated. The following statistically significant differences have been observed between FIL and LENO: the use of a higher number of vials (11 vs 7; P<0.03) to fully recover bone marrow, a higher grade 3–4 neutropenia at the time of G-CSF discontinuation (29.3% vs 16.7%; P=0.031) and an increased number of days of hospitalization (8 vs 5; P<0.005). A longer hospital stay before discharge was necessary (12 vs 10), which reflects the higher final costs per patient (median treatment cost per cycle 10.706 € for LENO, compared to 12.623 € for FIL).
Conclusion
The use of LENO has been associated with a lower number of days of hospitalization, number of vials and less incidence of grade 3–4 neutropenia at the time of G-CSF discontinuation. LENO seems to be cost-saving when compared with FIL (–15.2%).
Acknowledgments
The authors thank the nurses of the Hematology Department of AOU Careggi Firenze.
Disclosure
TP is an employee of Italfarmaco SpA; UR declares personal fees from Italfarmaco SpA and Bayer SpA outside the present work. The other authors report no other conflicts of interest in this work.