Efficacy and cost of G-CSF derivatives for prophylaxis of febrile neutropenia in lymphoma and multiple myeloma patients underwent autologous hematopoietic stem cell transplantation

Figures & data

Table 1. Cohort characteristics.

	pegfilgrastim group (n=43)	filgrastim Group (n=129)	P value
Sex
Female	23	59	0.898
Male	20	70
Median age(range,years)	38 (14-69)	41(12-64)	0.276
Disease
lymphoma	26	78	1.000
B-NHL	18	52
T-NHL	4	16
HL	4	10
MM	17	51
Cycles of chemotherapy before ASCT	6(3-11)	6(4-14)	0.189
Mobilization regimen
With plerixafor	0	0
Without plerixafor	43	129
Disease status before ASCT
CR	30	92	0.989
PR	8	23
VGPR(only for MM)	5	14
Conditioning regimen
BEAC	18	48	0.476
BEAM	12	26
Mel	13	55
Median MNC (range, ×10^8/kg)	6.0(4.07-9.53)	6.05(2.73-15.20)	0.354
Median CD34 positive cells (range, ×10^6/kg)	5.83(3.59-25.53)	5.45(2-36.1)	0.287

NHL: Non-Hodgkin's lymphoma.

HL: Hodgkin's lymphoma.

MM:Multiple myeloma.

ASCT: autologous stem cell transplantation.

CR: complete remission; PR: partial remission; VGPR: Very good partial remission.

BEAM: bis-chloroethylnitrosourea/etoposide/cytosine arabinoside/melphalan.

BEAC: bis-chloroethylnitrosourea /etoposide/cytosine arabinoside/cyclophosphamide.

Mel: melphalan.

MNC: mononuclear cells.

Figure 1. Neutrophil and platelet recovery between the two cohorts. Neutrophil recovery rates(A) and platelet recovery rates (B).

Figure 2. Causes of febrile neutropenia in the two cohorts.

Table 2. Infections complications in two groups.

	Pegfilgrastim (n=43)	Filgrastim (n = 129)	P value
Days with fever	1.8 ± 0.6	2.3 ± 0.8	0.047
Number of patients with infection	8(18.60%)	72(55.81%)	0.000
Number of patients with bacteremia	5(11.63%)	48(37.21%)	0.002
Number of patients with fungal infection	2(4.65%)	22(17.05%)	0.042
Number of patients with virus infection	1(2.33%)	2(1.55%)	0.737
Number of patients with febrile neutropenia	8(18.60%)	65(50.39%)	0.000

Figure 3. White blood cell counts on day 1 after injection of pegfilgrastim and duration of neutropenia in pegfilgrastim group patients with different primary diseases.White blood cell counts on the first day after injection of pegfilgrastim (A) and duration of neutropenia (B).

Table 3. Cost analysis in two groups.

	Pegfilgrastim (n = 43)	Filgrastim (n = 129)	P value
Cost of G-CSF(dollars)	525.78	617.22 ± 37.87	0.032
Cost of inpatient bed fee after transplant (dollars)	586.88 ± 154.93	666.69 ± 178.41	0.028
Cost Of antibiotics(dollars)	556.08 ± 79.44	731.57 ± 108.67	0.031
Cost of antifungal drugs(dollars)	351.19 ± 75.75	549.33 ± 110.62	0.022
Cost of infused platelets (range,dollars)	469.50(0-939.00)	469.50(234.75-1173.35)	0.819
Cost of infused red blood cells (range,dollars)	65.73(0-197.19)	65.73(0-131.46)	0.643
Cost other than G-CSF post-transplantation (dollars)	6157.63 ± 923.64	6588.67 ± 1231.52	0.0431