Supportive Care in Cancer

, Volume 23, Issue 7, pp 2045–2051 | Cite as

Comparison of filgrastim and pegfilgrastim to prevent neutropenia and maintain dose intensity of adjuvant chemotherapy in patients with breast cancer

  • Georgia KourlabaEmail author
  • Meletios A. Dimopoulos
  • Dimitrios Pectasides
  • Dimosthenis V. Skarlos
  • Helen Gogas
  • George Pentheroudakis
  • Angelos Koutras
  • George Fountzilas
  • Nikos Maniadakis
Original Article



The aim of this study was to compare the effectiveness of prophylactic single fixed dose of pegfilgrastim and daily administration of filgrastim on febrile neutropenia (FN), severe neutropenia, treatment delay, and dose reduction in patients with breast cancer receiving dose-dense adjuvant chemotherapy.


A retrospective cohort study with 1058 breast cancer patients matched by age and chemotherapy was conducted. The primary endpoints were FN, severe (grade 3, 4) neutropenia, dose reduction (>10 % reduction of the dose planned), and treatment delay (dose given more than 2 days later).


Eighteen episodes of FN (3.4 %) in the filgrastim group and 23 (4.3 %) in the pegfilgrastim group (p = 0.500) were recorded. More than half of the total episodes (27/41) occurred during the first 4 cycles of treatment. Patients who received filgrastim were almost three times more likely to experience a severe neutropenia episode and were significantly more likely to experience a dose reduction (18.5 %) compared to those who received pegfilgrastim (10.8 %) (p < 0.001). The percentage of patients, who received their planned dose on time, was significantly lower in patients receiving filgrastim (58 %) compared to those receiving pegfilgrastim (72.4 %, p < 0.001).


No significant difference was detected on FN rate between daily administration of filgrastim and single administration of pegfilgrastim. However, patients receiving pegfilgrastim had a significantly lower rate of severe neutropenia, as well as dose reduction and treatment delay, thus, achieving a higher dose density.


Breast cancer Dose-dense chemotherapy Greece Neulasta Neutropenia 



The authors wish to thank all Hellenic Cooperative Oncology Group coordinators for data collection, Ms. E. Fragou for study monitoring, Ms. M. Moschoni for data management, and Mw. N. Sotiriadou for secretarial assistance.

Conflict of interest

There is no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Georgia Kourlaba
    • 1
    Email author
  • Meletios A. Dimopoulos
    • 2
  • Dimitrios Pectasides
    • 3
  • Dimosthenis V. Skarlos
    • 4
  • Helen Gogas
    • 5
  • George Pentheroudakis
    • 6
  • Angelos Koutras
    • 7
  • George Fountzilas
    • 8
  • Nikos Maniadakis
    • 9
  1. 1.The Stavros Niarchos Foundation-Collaborative Center for Clinical Epidemiology and Outcomes Research (CLEO)National and Kapodistrian University of Athens School of MedicineAthensGreece
  2. 2.Department of Clinical Therapeutics, “Alexandra” HospitalUniversity of Athens School of MedicineAthensGreece
  3. 3.Oncology Section, Second Department of Internal Medicine“Hippokration” HospitalAthensGreece
  4. 4.Second Department of Medical Oncology“Metropolitan” HospitalPiraeusGreece
  5. 5.First Department of Medicine, “Laiko” General HospitalUniversity of Athens, Medical SchoolAthensGreece
  6. 6.Department of Medical OncologyIoannina University HospitalIoanninaGreece
  7. 7.Division of Oncology, Department of Medicine, University HospitalUniversity of Patras Medical SchoolPatrasGreece
  8. 8.Department of Medical Oncology, “Papageorgiou” HospitalAristotle University of Thessaloniki School of MedicineThessalonikiGreece
  9. 9.Department of Health Services Organisation & ManagementNational School of Public HealthAthensGreece

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