Comparison of Subcutaneous Versus Intravenous Filgrastim in Autologous Hematopoietic Stem Cell Transplantation: A Retrospective Study

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PURPOSE: Filgrastim is administered to shorten the duration of chemotherapy-induced neutropenia. Filgrastim can be administered intravenously or subcutaneously, but different routes of administration may result in different pharmacokinetic properties, which may affect efficacy. The primary objective of this study was to determine if subcutaneous (SQ) filgrastim would be associated with a shorter time to neutrophil recovery in patients with myeloma undergoing autologous hematopoietic stem cell transplantation (autoHSCT) when compared to intravenous piggyback (IVPB) filgrastim. METHODS: This was a single-center, retrospective cohort study of patients undergoing autoHSCT for myeloma admitted and discharged between 2018 and 2019. The primary outcome was the mean number of days from transplant day 0 to absolute neutrophil count (ANC) greater than 500 cells/μL. Secondary outcomes were the incidence of and mean number of days of gram-negative antibiotic treatment and 30-day mortality. RESULTS: A total of 196 patients with myeloma met the inclusion criteria. No significant differences in time to neutrophil recovery between IVPB and SQ filgrastim were observed (11.0 ± 0.7 days vs. 10.8 ± 0.8 days, p = 0.15, respectively). No significant differences were observed in any of the secondary outcomes between IVPB and SQ filgrastim. CONCLUSION: In patients with myeloma undergoing autoHSCT, no differences in time to neutrophil recovery, incidence of or duration of gram-negative antibiotic treatment, or 30-day mortality were observed between IVPB and SQ routes of filgrastim administration.

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