Telpegfilgrastim for the prophylaxis of chemotherapy-induced neutropenia in patients with high- or medium-risk non-myeloid malignancies: a multicenter, retrospective study

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BACKGROUND: Chemotherapy-induced neutropenia (CIN) and febrile neutropenia (FN) pose significant risks in patients with non-myeloid malignancies. This study aimed to evaluate the efficacy and safety of telpegfilgrastim in CIN prevention. METHODS: This multicentre retrospective study enrolled 110 patients with high-/medium-risk non-myeloid malignancies receiving chemotherapy and telpegfilgrastim prophylaxis, and divided them into 2nd day (83 patients) and 3rd day (27 patients) groups. The primary outcome was the incidence of grade 3/4 CIN, whereas the secondary outcomes included FN incidence, antibiotic usage, and infection rate. Subgroup analyses were conducted for absolute neutrophil counts (ANC), primary/secondary prophylaxis, and single-/multicycle medication. RESULTS: The incidence of grade 3/4 CIN was 5.59% in the 2nd day group and 8.89% in the 3rd day group. The 2nd day group reported no cases of FN, whereas the 3rd day group exhibited an incidence of 2.22%. Antibiotic usage and the incidence of infection were relatively lower in the 2nd day group. In the 2nd day group, ANC significantly increased to the normal level in the first cycle and remained higher than baseline after multiple cycles; however, the 3rd day group showed no significant change. In primary prophylaxis, the incidence of grade 3/4 CIN was 2.82% in the 2nd day group and 4.17% in the 3rd day group; in secondary prophylaxis, it was 7.78% and 14.29%, respectively, with an incidence rate ratio of 0.35 (P = 0.028) comparing primary to secondary prophylaxis. Bone pain was reported in one patient in each group, with no serious adverse events overall. CONCLUSIONS: Telpegfilgrastim administered on the 2nd and 3rd day after chemotherapy effectively reduced the risk of CIN and FN. Besides this, primary prophylaxis is more beneficial.

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