Background: Neutropenia is a common and serious complication encountered during chemotherapy treatment of cancer patients. The incidence of neutropenia increases the risk of infection and can influence the chemotherapy treatment in terms of drug dosage and treatment duration. Mecapegfilgrastim is a novel, long-acting pegylated recombinant human granulocyte-colony stimulating factor (PEG-rhG-CSF) designed to prevent the incidence of neutropenia. The study aims to observe the effectiveness and safety of mecapegfilgrastim as prophylaxis for chemotherapy-induced neutropenia in patients with lymphoma.
Methods: Ninety-one patients with lymphoma were enrolled and received mecapegfilgrastim as either primary or secondary prophylaxis. The incidence of grade III/IV neutropenia, the duration of grade III/IV neutropenia in the overall population, and the differences between the primary and secondary prophylaxis groups were investigated. Adverse events were also recorded.
Results: During the first chemotherapy cycle, the incidence of grade III and grade IV neutropenia was 5% and 7%, respectively. Of the 71 patients who received mecapegfilgrastim as primary prophylaxis, the incidence of grade III and grade IV neutropenia was 4% and 1%, respectively. Of the 20 patients who received mecapegfilgrastim as secondary prophylaxis, the incidence of grade III and grade IV neutropenia was 10% and 25%, respectively. The mean duration of grade III neutropenia was 0.85 days. The mean duration of grade III neutropenia in patients who received mecapegfilgrastim as primary prophylaxis was one day less than patients who received mecapegfilgrastim as secondary prophylaxis. Fever and bone/muscle pain were the most frequently observed adverse events.
Conclusions: Mecapegfilgrastim is more effective in reducing the incidence of grade III/IV neutropenia and the mean duration of febrile neutropenia (FN) when used as primary prophylaxis rather than secondary prophylaxis in patients with lymphoma. The toxicity of mecapegfilgrastim was tolerable.
Keywords: Mecapegfilgrastim; lymphoma; neutropenia.