Experience in prevention of neutropenia in patients with disseminated soft tissue sarcomas receiving polychemotherapy

Abstract

The main treatment for metastatic soft tissue sarcomas is chemotherapy (CT); neutropenia is its frequent complication that is treated with various colony stimulating factors (CSFs). The purpose of the study was to assess the treatment effectiveness and frequency of adverse events in administration of various CSFs (filgrastim, pegfilgrastim and lipegfilgrastim) in patients with disseminated soft tissue sarcomas receiving myelosuppressive CT. Data on 34 patients firstly diagnosed with disseminated soft tissue sarcomas were studied; the patients received 4 cycles of CT: doxorubicin plus ifosfamide, combined with CSFs: filgrastim daily or a single injection of long-acting CSFs. Following results were received: both duration and severity of neutropenia were highest in the filgrastim group. Frequency of febrile neutropenia requiring antibacterial treatment and the number of cases of discontinuation of cytostatics or dose reduction associated with hematological complications during the cycles 1-4 were significantly lower in patients receiving pegfilgrastim and lipegfilgrastim. Musculoskeletal pain was the most frequent adverse event during cytokine administration. Thus, a single injection of pegfilgrastim and lipegfilgrastim contributed to a significant reduction of neutropenia duration and severity, compared with daily filgrastim, with similar safety profiles of the drugs.

Keywords

• chemotherapy
• febrile neutropenia
• granulocyte colony stimulating factor
• filgrastim
• pegfilgrastim
• lipegfilgrastim
• soft tissue sarcomas