Comparative study on the effects of filgrastim and pegfilgrastim in the treatment of fever and neutropenia in patients with leukemia in the west of Iran

Mohammad Reza Golpayegani; Pooya Faranoush; Mohammad Hossein Rasouli; Mohammadreza Foroughi-Gilvaee; Negin Sadighnia; Ashkan Zandi; SeyedMohammad Sadegh  Mosavi-Kiasary; Mohammad Faranoush

doi:10.18502/ijpho.v12i2.9072

Mohammad Reza Golpayegani Department of Pediatrics, School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Pooya Faranoush Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, P.O. Box: 1996713883, Tehran, Iran.
Mohammad Hossein Rasouli School of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
Mohammadreza Foroughi-Gilvaee Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, P.O. Box: 1996713883, Tehran, Iran.
Negin Sadighnia Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, P.O. Box: 1996713883, Tehran, Iran.
Ashkan Zandi Nano Bio Electronic Devices Lab, Cancer Electronics Research Group, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, P.O. Box: 14395/515, Tehran, Iran.
SeyedMohammad Sadegh Mosavi-Kiasary Nano Bio Electronic Devices Lab, Cancer Electronics Research Group, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, P.O. Box: 14395/515, Tehran, Iran.
Mohammad Faranoush Pediatric Growth and Development Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, P.O. Box: 1996713883, Tehran, Iran.

DOI: https://doi.org/10.18502/ijpho.v12i2.9072

Keywords: Children, Febrile neutropenia, Filgrastim, Leukemia, Pegfilgrastim

Abstract

Background: The current research seeks to present a comparative study of the effect of filgrastim and pegfilgrastim in the treatment of fever and neutropenia in leukemia patients.

Materials and Methods: The present study is a blind randomized clinical trial. The study population is comprised of 120 children with acute lymphoblastic leukemia (ALL) who were admitted to the hospital due to mild febrile neutropenia during 2019. Included patients were divided into two groups. Filgrastim (10 micrograms/ kilogram, daily subcutaneously) and pegfilgrastim (100 micrograms per kilogram of a subcutaneous dose) were used for groups, respectively. Fever monitored every 6 hours, and neutrophil count was performed every 48 hours. The questionnaire designed in the study included age, type of drug side effects, number of days of neutropenia, and fever cessation time. Then, the data were analyzed by SPSS software.

Result: Leukemic children with fever and neutropenia (N=120) were included in the study, which was 59 (49.1%) male and 61 (50.9%) female by the mean age of 79±44 months. The mean days of neutropenia correction in the filgrastim and pegfilgrastim groups were 5 and 4 days, respectively, which was not significantly different (p =0.08). There was no correlation between patients’ complications and types of treatments (p>0.05). Muscular pain was the most common complication observed among 4 cases and 1 case following filgrastim and pegfilgrastim administration, respectively. Furthermore, hyperleukocytosis following pegfilgrastim consumption was observed in two cases.

Conclusion: There was no significant correlation between the duration until the cessation of fever and the number of neutropenia days in the two groups receiving pegfilgrastim and filgrastim. Therefore, the fever and neutropenia improve with pegfilgrastim earlier than filgrastim; besides, fewer injections, patient comfort, and less musculoskeletal pain can be observed.