BENEFITS OF GRANULOCYTE-COLONY-STIMULATING FACTOR AFTER STEM-CELL TRANSFUSION IN INTENSIVE SEQUENTIAL CHEMOTHERAPY FOR BREAST-CANCER

The aim of this study was to evaluate the clinical and economic benefi t of filgrastrin given with intensive sequential chemotherapy. Women w ith poor-prognosis breast cancer received four cycles of high-dose cyc lophosphamide (3 g/m(2)) and doxorubicin (75 mg/m(2)), followed by fil grastim 5 mu g/kg/dy, stem cell collection after the cycle 1, and stem cell infusion after cycle 3 and cycle 4. The first cohort received fi lgrastim after the fourth cycle but the second cohort did not. Thirty three patients were included in the first cohort and 13 in the second. The results indicate that the duration of grade IV neutropenia was sh orter in the group given filgrastim as was the median time to recover an absolute neutrophil count (ANC) > 1.0 x 10(9)/L. The rate and durat ion of the rehospitalizations were higher in the group not receiving f ilgrastim, We found that costs such as drugs and hospitalizations were significantly higher (p = 0.032 and p = 0.019) in the non-filgrastim- treated group. Using ANC > 1.0 x 10(9)/L as an intermediary efficiency criterion it was more cost effective to give filgrastim. It can be co ncluded from this study that filgrastim can decrease the duration of g rade IV neutropenia in patients receiving intensive sequential chemoth erapy. This, in turn, reduces the cost of hospitalization. However, in our study, this reduction of neutropenia did not have any impact on f urther therapy.