Use of granulocyte colony-stimulating factors with multiagent chemotherapy for high-risk gestational trophoblastic neoplasia decreases neutropenic complications and treatment delays

Margaux J. Kanis, Richard A. Greendyk, Janelle Sobecki-Rausch, Megan E. Dayno, John Robert Lurain III*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

OBJECTIVE: To evaluate the use of granulocyte colonystimulating factors (G-CSFs) in preventing neutropenic complications and treatment delays in patients receiving multiagent chemotherapy for high-risk gestational trophoblastic neoplasia (GTN). STUDY DESIGN: Twentyfive patients received multiagent chemotherapy for highrisk GTN from 2001–2016. G-CSFs were administered as secondary therapy in the EMA-CO protocol and as primary therapy in the EMA-EP, BEP, VIP, ICE, and TP/TE regimens. Patient and disease characteristics, number of chemotherapy cycles and regimens, morbidity, treatment delays, and outcomes were evaluated. RESULTS: Twenty-one (84%) of 25 high-risk GTN patients received G-CSFs: 4 as secondary therapy in the 23 patients who received EMA-CO and 17 as primary prophylaxis in those receiving platinum-containing regimens. Only 20 (7.6%) of 264 total chemotherapy cycles were delayed due to neutropenia. Dose reductions were necessary in only 2.3% of chemotherapy cycles. Neutropenic fever was associated with 3% of chemotherapy cycles. Eight patients (32%) had minor side effects attributable to G-CSFs. Overall survival was 88%. CONCLUSION: In treating high-risk GTN with multiagent chemotherapy regimens, G-CSFs administered secondarily after a neutropenic complication or as primary prophylaxis in patients at high risk for febrile neutropenia decreases morbidity, treatment delays, and dose reductions, resulting in improved outcomes.

Original languageEnglish (US)
Pages (from-to)209-212
Number of pages4
JournalJournal of Reproductive Medicine
Volume63
Issue number3
StatePublished - Jan 1 2018

Keywords

  • Chemotherapy
  • G-CSF
  • Gestational trophoblastic disease
  • Gestational trophoblastic neoplasia
  • Granulocyte colony-stimulating factors
  • Neutropenia
  • Neutropenic fever

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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