Skip to main content

Advertisement

SpringerLink
Log in

Chemotherapy-induced anemia in breast cancer patients treated with pegfilgrastim-supported dose-dense regimens

  • Short Communication
  • Published:
Clinical and Experimental Medicine Aims and scope Submit manuscript

Abstract

The primary use of recombinant granulocyte colony-stimulating factors has reduced the incidence of febrile neutropenia during dose-dense adjuvant/neoadjuvant chemotherapy programs for breast cancer. Otherwise, in this population, filgrastim seems to worse chemotherapy-induced anemia, especially when administered with prolonged schedules that induced leukocytosis. No exhaustive data are available about the effect of long-lasting formulation of filgrastim (pegfilgrastim) on hemoglobin levels. We retrospectively analyzed the data regarding hemoglobin level and leukocyte count of 38 breast cancer patients treated with dose-dense anthacycline and/or taxane-based chemotherapy with pegfilgrastim support, both in adjuvant and in neoadjuvant settings. Mean hemoglobin levels progressively decreased throughout the treatment (without correlation with both the schedule of chemotherapy and the patient’s age) but only two patients developed mild anemia. No significant correlation was found between the degree of leukocytosis and the hemoglobin decrease. These data suggest that pegfilgrastim, per se, doesn’t seem to worse chemotherapy-induced anemia. This fact may be at least in part explains by its “balanced” impact on hematopoietic recovery during dose-dense chemotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Citron ML, Donald AB, Cirrincione C, Hudis C, Winer EP, Gradishar WJ et al (2003) Randomized trial of dose-dense versus conventionally scheduled and sequential versus concurrent combination chemotherapy as postoperative adjuvant treatment of node-positive primary breast cancer: first report of Intergroup trial C9741/Cancer and Leukemia Group B Trial 9741. J Clin Oncol 21(8):1431–1439

    Article  CAS  PubMed  Google Scholar 

  2. Kuderer NM, Dale DC, Crawford J, Lyman GH (2007) Impact of primary prophylaxis with granulocyte colony-stimulating factor on febrile neutropenia and mortality in adult cancer patients receiving chemotherapy: a systematic review. J Clin Oncol 25(21):3158–3167

    Article  CAS  PubMed  Google Scholar 

  3. Papaldo P, Lopez M, Marolla P, Cortesi E, Antimi M, Terzoli E et al (2005) The impact of five prophylactic filgrastim schedules on hematologic toxicity in early breast cancer patients treated with epirubicin and cyclophosphamide. J Clin Oncol 23:6908–6918

    Article  CAS  PubMed  Google Scholar 

  4. Papaldo P, Ferretti G, Di Cosimo S, Giannarelli D, Marolla P, Lopez M et al (2006) Does granulocyte colony-stimulating factor worsen anemia in early breast cancer patients treated with epirubicin and cyclophosphamide? J Clin Oncol 24(19):3048–3055

    Article  CAS  PubMed  Google Scholar 

  5. Schippinger W, Holub R, Dandachi N, Bauernhofer T, Samonigg H (2006) Frequency of febrile neutropenia in breast cancer patients receiving epirubicin and docetaxel/paclitaxel with colony-stimulating growth factors: a comparison of filgrastim or lenograstim with pegfilgrastim. Oncology 70:290–293

    Article  CAS  PubMed  Google Scholar 

  6. Von Minckwitz G, Kummel S, du Bois A, Eiermann W, Eidtmann H, Gerber B et al (2008) Pegfilgrastim ± ciprofloxacin for primary prophylaxis with TAC (docetaxel/doxorubicin/cyclophosphamide) chemotherapy for breast cancer. Results from GEPARTRIO study. Ann Oncol 19:292–298

    Article  Google Scholar 

  7. Dang C, Fornier M, Sugarman S, Troso-Sandoval T, Lake D, D’Andrea G et al (2008) The safety of dose-dense doxirubicin and cyclophosphamide followed by paclitaxel with trastuzumab in HER-2/neu overexpressed/amplified breast cancer. J Clin Oncol 26(9):1216–1222

    Article  CAS  PubMed  Google Scholar 

  8. Burstein HJ, Parker LM, Keshaviah A, Doherty J, Partridge AH, Schapira L et al (2005) Efficacy of pegfilgrastim and darbepoietin-α as hemopoietic support for dose-dense every-2-week adjuvant breast cancer chemotherapy. J Clin Oncol 23:8340–8347

    Article  CAS  PubMed  Google Scholar 

  9. De Hann G, Loeffler M, Nijhof W (1999) Long-term recombinant human granulocyte colony-stimulating factor treatment severely depresses murine marrow erythropoiesis without causing anaemia. Exp Hematol 20:600–604

    Google Scholar 

  10. Wolff AC, Jones RJ, Davidson NE, Jeter SC, Stearns V (2006) Myeloid toxicity in breast cancer patients receiving adjuvant chemotherapy with pegfilgrastim support. J Clin Oncol 24:2392–2394

    Article  PubMed  Google Scholar 

  11. Danova M, Bencardino K, Manzoni M, Grasso D, Mariucci S, Rovati B (2007) In vivo biological effects of pegfilgrastim after myelosuppressive chemotherapy in breast cancer. Anticancer Res 27:3339–3402

    Google Scholar 

Download references

Conflict of interest statement

The authors declare that they have no conflict of interest related to the publication of this manuscript.

Author information

Authors and Affiliations

  1. Medical Oncology, Foundation IRCCS Policlinico S. Matteo, Piazzale C. Golgi 2, 27100, Pavia, Italy

    Mariangela Manzoni, Sara Delfanti, Bianca Rovati, Donatella Grasso, Sara Mariucci, Katia Bencardino & Marco Danova

  2. Clinical Epidemiology and Biometric Unit, Foundation IRCCS Policlinico S. Matteo, Pavia, Italy

    Carmine Tinelli

Authors
  1. Mariangela Manzoni
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sara Delfanti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bianca Rovati
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Donatella Grasso
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Sara Mariucci
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Katia Bencardino
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Carmine Tinelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Marco Danova
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mariangela Manzoni.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Manzoni, M., Delfanti, S., Rovati, B. et al. Chemotherapy-induced anemia in breast cancer patients treated with pegfilgrastim-supported dose-dense regimens. Clin Exp Med 10, 135–138 (2010). https://doi.org/10.1007/s10238-009-0072-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10238-009-0072-y

Keywords

Search

Navigation