TY - JOUR
T1 - Use of granulocyte colony-stimulating factors with multiagent chemotherapy for high-risk gestational trophoblastic neoplasia decreases neutropenic complications and treatment delays
AU - Kanis, Margaux J.
AU - Greendyk, Richard A.
AU - Sobecki-Rausch, Janelle
AU - Dayno, Megan E.
AU - Lurain III, John Robert
PY - 2018/1/1
Y1 - 2018/1/1
N2 - 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.
AB - 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.
KW - Chemotherapy
KW - G-CSF
KW - Gestational trophoblastic disease
KW - Gestational trophoblastic neoplasia
KW - Granulocyte colony-stimulating factors
KW - Neutropenia
KW - Neutropenic fever
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M3 - Article
AN - SCOPUS:85048031796
SN - 0024-7758
VL - 63
SP - 209
EP - 212
JO - Journal of Reproductive Medicine
JF - Journal of Reproductive Medicine
IS - 3
ER -