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Among Hodgkin’s lymphoma patients treated with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) chemotherapy every two weeks, use of Neulasta® (pegfilgrastim) was safe and allowed most patients to receive their chemotherapy on schedule. These results were published in the European Journal of Cancer.

Hodgkin’s lymphoma is a cancer of the lymph system. It is diagnosed when a characteristic cell (the Reed-Sternberg cell) is identified under a microscope. Hodgkin’s lymphoma typically begins in the lymph nodes in one region of the body and then spreads through the lymph system in a predictable manner. It may spread outside the lymph system to other organs such as the lungs, liver, bone, and bone marrow.

Neutropenia is a condition characterized by abnormally low blood levels of infection-fighting neutrophils, a specific kind of white blood cell. Febrile neutropenia refers to neutropenia accompanied by fever.

The most common reason that cancer patients experience neutropenia is as a side effect of chemotherapy. Chemotherapy involves the use of drugs to destroy cancer cells. Chemotherapy works by destroying cells that grow rapidly, a characteristic of cancer cells. Unfortunately, chemotherapy also affects normal cells that grow rapidly, such as blood cells in the bone marrow, cells in the hair follicles, or cells in the mouth and intestines.

Chemotherapy-induced neutropenia is important because it may increase a patient’s risk of life-threatening infection and may disrupt the delivery of cancer treatment. For patients at high risk of developing neutropenia, blood cell growth factors such as Neulasta® (pegfilgrastim) can be used to reduce the risk.

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To explore the safety and efficacy of Neulasta among Hodgkin’s lymphoma patients receiving chemotherapy every two weeks, researchers conducted a study among 23 patients. Fifty seven percent of patients had Stage I or Stage IIA Hodgkin’s lymphoma, and 43% had advanced-stage Hodgkin’s lymphoma.

Patients were treated with three to six courses of ABVD chemotherapy followed by involved-field radiation therapy. Roughly 24 hours after each chemotherapy infusion, patients received one dose of Neulasta.

  • None of the patients experienced febrile neutropenia.
  • Only two patients experienced a very low absolute neutrophil count (ANC).
  • 94% of ABVD doses were administered on time.
  • Severe (grade 3 or grade 4) bone pain was experienced by one patient.

The researchers conclude that among Hodgkin’s lymphoma patients treated with ABVD chemotherapy every two weeks, use of Neulasta was safe and highly effective in preventing neutropenia-related delays in chemotherapy.

Reference: Younes A, Fayad L, Romaguera J, Pro B, Goy A, Wang M. Safety and Efficacy of Once-per-cycle Pegfilgrastim in Support of ABVD Chemotherapy in Patients with Hodgkin Lymphoma. European Journal of Cancer. 2006;42:2976-2981.