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Evidence summaries

Granulopoiesis-Stimulating Factors to Prevent Adverse Effects in the Treatment of Malignant Lymphoma

Prophylactic treatment with granulopoiesis-stimulating factor reduces the risk for neutropenia, febrile neutropenia and infections in patients undergoing conventional chemotherapy for malignant lymphoma, but does not improve overall survival or freedom from treatment failure. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 13 studies with a total of 2 607 subjects. Compared with no prophylaxis, both granulocyte-colony-stimulating factor (G-CSF) and granulocyte-macrophage-colony-stimulating factor (GM-CSF) did not improve overall survival (HR 0.97, 95% CI 0.87 to 1.09; 10 studies, n=2221) or freedom from treatment failure (FFTF) (HR 1.11, 95% CI 0.91 to 1.35; 5 studies, n=718). Prophylaxis significantly reduced the risk for severe neutropenia (RR 0.67, 95% CI 0.60 to 0.73; 7 studies, n=1013), febrile neutropenia (RR 0.74, 95% CI 0.62 to 0.89; 4 studies, n=360) and infection (RR 0.74, 95% CI 0.64 to 0.85; 9 studies, n=1292). There was no evidence that either G-CSF or GM-CSF reduced the number of patients requiring intravenous antibiotics (RR 0.82, 95%CI 0.57 to 1.18; 4 studies, n=359); lowered infection related mortality (RR 0.93, 95% CI 0.51 to 1.71; 10 studies, n=1835); or improved complete tumour response (RR 1.03, 95% CI 0.95 to 1.10; 11 studies, n=2368).One study evaluated quality of life parameters and found no differences between the treatment groups.

    References

    • Bohlius J, Herbst C, Reiser M, Schwarzer G, Engert A. Granulopoiesis-stimulating factors to prevent adverse effects in the treatment of malignant lymphoma. Cochrane Database Syst Rev 2008;(4):CD003189. [PubMed]

Primary/Secondary Keywords