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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Primary prophylaxis with G-CSF may improve outcomes in patients with newly diagnosed stage III/IV Hodgkin lymphoma treated with brentuximab vedotin plus chemotherapy

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  • David Straus
  • Graham Collins
  • Jan Walewski
  • Pier Luigi Zinzani
  • Andrew Grigg
  • Anna Sureda
  • Arpad Illes
  • Tae Min Kim
  • Sergey Alekseev
  • Lena Specht
  • Valeria Buccheri
  • Anas Younes
  • Joseph Connors
  • Andres Forero-Torres
  • Keenan Fenton
  • Ashish Gautam
  • Indra Purevjal
  • Rachael Liu
  • Andrea Gallamini
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We investigate the impact of granulocyte-colony stimulating factor (G-CSF) primary prophylaxis (G-PP, N = 83) versus no G-PP (N = 579) on safety and efficacy of brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A + AVD) in the ECHELON-1 study of previously untreated stage III/IV classical Hodgkin lymphoma. G-PP was associated with lower incidence of ≥ grade 3 neutropenia (29% versus 70%) and febrile neutropenia (11% versus 21%). Fewer dose delays (35% versus 49%), reductions (20% versus 26%), and hospitalizations (29% versus 38%) were observed. Seven neutropenia-associated deaths occurred in the A + AVD arm; none received G-PP. A + AVD with G-PP was associated with decreased risk of a modified progression-free survival event by 26% compared with A + AVD alone (95% CI: 0.40-1.37). G-PP reduced the rate and severity of adverse events, including febrile neutropenia, reduced treatment delays, dose reductions, and discontinuations, and may thus improve efficacy outcomes. These data support G-PP for all patients treated with A + AVD.

Original languageEnglish
JournalLeukemia and Lymphoma
Volume61
Issue number12
Pages (from-to)2931-2938
Number of pages8
ISSN1042-8194
DOIs
Publication statusPublished - Dec 2020

    Research areas

  • Hodgkin lymphoma, brentuximab vedotin, frontline therapy, growth factor, primary prophylaxis

ID: 61755772