The use of filgrastim in patients with hodgkin lymphoma receiving ABVD

Background: there is conflicting data about the increased risk of pulmonary toxicity when granulocyte-stimulating factor (g-csf) is given in combination with bleomycin. no clear consensus for management of patients with hodgkin lymphoma (hl) who require g-csf support exists. our objective was to evaluate whether there is an increase in pulmonary toxicity in patients who receive bleomycin and g-csf during treatment for hl. materials and methods: we conducted a single-center retrospective analysis of patients with hodgkin lymphoma from january 2003 until july 2015. all patients who received at least 1 dose of bleomycin and followed at our institution were included. patients were evaluated for pulmonary toxicity starting from the day of first dose of bleomycin until 1 year after initiation of bleomycin. data on pre-identified risk factors for pulmonary toxicity were also collected. results: fifty-four patients met inclusion criteria. twenty-one patients received bleomycin alone,and 33 patients received bleomycin and g-csf. there was no statistically significant (p = 0.50) difference in the development of pulmonary toxicity between the two groups. crude hazard ratio for development of pulmonary toxicity in the bleomycin and g-csf cohort was 1.58 (95% confidence interval,ci: 0.41-6.12). on multivariate analysis,the hazard ratio for development of pulmonary toxicity was 1.71 (95% ci: 0.43-6.81). conclusion: this study does not find evidence that the combination of bleomycin and g-csf increases the risk for bleomycin-induced pulmonary toxicity. we recommend g-csf use in hl patients receiving bleomycin when needed to maintain dose intensity. © 2017 international journal of hematology-oncology and stem cell research,all right reserved.