The comparison of the preventive effects of filgrastim and lenograstim in pediatric cancer patients treated with chemotherapy and radiotherapy

OBJECTIVES: To compare the preventive effects of filgrastim and lenograstim in pediatric cancer patients treated with chemotherapy and radiotherapy. METHODS: Eighty-two patients treated with myelosuppressive chemotherapy and/or radiotherapy in Pediatric Oncology and Radiation Oncology Departments of Kocaeli University, Faculty of Medicine between September 2005 and March 2007 were randomized to filgrastim and lenograstim arms. Radiotherapy doses and fields 3 weeks prior to the therapy, age, gender, histopathological type of the tumor, stage and chemotherapy protocols were recorded. Patients with bone marrow infiltration due to the tumoral invasion and patients receiving steroid including chemotherapy regimens were excluded from the study. Equivalent doses of two hematopoetic growth factors (filgrastim 5 μg/kg/day, S.C; lenograstim 150 μg/m2/day, S.C) were applied beginning 24 hours following the completion of the chemotherapy till leukocyte count reached 10.000/mm3. RESULTS: Delay in the new chemotherapy cure following chemotherapy protocol was median 5 days in lenograstim arm (16 patients, 37%) while it was 3 days in filgrastim arm (10 patients; %25) however the difference was not statistically significant (p=0.188). In lenogastrim arm, febrile neutropenia occurred in 6 patients and infections without neutropenia were seen in 4 patients (pneumonia in 2 patients, otitis media in 1 patient and pharengitis in 1 patient). In filgrastim arm, febrile neutropenia occurred in 3 patients and gingivitis and gastroenteritis in 2 patients and the difference between two groups was also not significant (p=0.258). However, bone pain was present in 2 patients in lenograstim arm while it was seen in 10 patients in filgrastim arm with a significant difference (p=0.008). CONCLUSION: Although preventive effects of filgrastim and lenograstim on febrile neutropenia and non-neutropenic infections in patients receiving radiotherapy and chemotherapy are not significantly different, delay in the new chemotherapy cure following chemotherapy protocol is shorter in filgrastim arm. However, bone pain is also significantly higher in filgrastim arm.