The Use of Filgrastim in Patients with Hodgkin Lymphoma Receiving ABVD

  • Adam F. Binder Montefiore Medical Center 111 East 210th Street Bronx, NY 10467
  • Sonia Rai Icahn School of Medicine at Mount Sinai 1 Gustave L Levy Place New York, NY 10029
  • Amir Steinberg Icahn School of Medicine at Mount Sinai 1 Gustave L Levy Place New York, NY 10029
Keywords: Bleomycin, Granulocyte stimulating factor, Bleomycin induced-pulmonary injury, Hodgkin lymphoma, Treatment complications


Background: There is conflicting data about the increased risk of pulmonary toxicity when granulocyte-stimulating factor (G-CSF) is given in combination with bleomycin. No clear consensus for management of patients with Hodgkin lymphoma (HL) who require G-CSF support exists. Our objective was to evaluate whether there is an increase in pulmonary toxicity in patients who receive bleomycin and G-CSF during treatment for HL. Materials and Methods: We conducted a single-center retrospective analysis of patients with Hodgkin Lymphoma from January 2003 until July 2015. All patients who received at least 1 dose of bleomycin and followed at our institution were included. Patients were evaluated for pulmonary toxicity starting from the day of first dose of bleomycin until 1 year after initiation of bleomycin. Data on pre-identified risk factors for pulmonary toxicity were also collected.Results: Fifty-four patients met inclusion criteria. Twenty-one patients received bleomycin alone, and 33 patients received bleomycin and G-CSF. There was no statistically significant (p = 0.50) difference in the development of pulmonary toxicity between the two groups. Crude hazard ratio for development of pulmonary toxicity in the bleomycin and G-CSF cohort was 1.58 (95% confidence interval, CI: 0.41-6.12). On multivariate analysis, the hazard ratio for development of pulmonary toxicity was 1.71 (95% CI: 0.43-6.81).Conclusion: This study does not find evidence that the combination of bleomycin and G-CSF increases the risk for bleomycin- induced pulmonary toxicity. We recommend G-CSF use in HL patients receiving bleomycin when needed to maintain dose intensity.

Author Biographies

Adam F. Binder, Montefiore Medical Center 111 East 210th Street Bronx, NY 10467
Assistant ProfessorDepartment of Hematology/Oncology
Amir Steinberg, Icahn School of Medicine at Mount Sinai 1 Gustave L Levy Place New York, NY 10029
Assistant ProfessorDivision of hematology/Oncology


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How to Cite
Binder A, Rai S, Steinberg A. The Use of Filgrastim in Patients with Hodgkin Lymphoma Receiving ABVD. ijhoscr. 11(4):286-92.
Original Article(s)