Safety and efficacy of once-per-cycle pegfilgrastim in support of ABVD chemotherapy in patients with Hodgkin lymphoma.

The objective of this prospective study was to examine the safety and efficacy of pegfilgrastim in support of chemotherapy regimens that are administered every 14 d. Patients with Hodgkin lymphoma receiving standard ABVD (doxorubicin, bleomycin, vinblastine, and decarbazine) chemotherapy every 14 d were eligible for the study. All patients received one fixed dose of 6 mg pegfilgrastim approximately 24h after each ABVD infusion. Absolute neutrophil counts (ANCs) were measured weekly while on therapy. After completion of therapy, ANCs were measured every 3-4 months for 2 years, and every 6 months thereafter. Twenty-three patients received 115 courses (230 doses) of ABVD. Nadir ANC below 0.5 x 10(9)/L was observed only in two cases (1.1%), and ANC counts on the day of ABVD therapy below 1 x 10(9)/L was observed only once (0.4%). No neutropenic fever was observed. Two hundred and fifteen (93.5%) doses of ABVD were given on time as scheduled. Grade 3/4 bone pain was observed after 0.4% of ABVD doses, and bleomycin lung toxicity was observed in two patients. With a median follow-up of 29 months after completion of ABVD, no myelodysplastic syndrome was observed. Two patients relapsed and subsequently underwent successful stem cell collection and transplantation. Pegfilgrastim was found to be safe in support of ABVD chemotherapy that is administered every 14 d. Pegfilgrastim was also effective in maintaining ABVD dose intensity, and keeping planned dose of chemotherapy on schedule.