Sari, N., Dalva, K., & Ilhan, I.E. (2013). Comparison of filgrastim and lenograstim in pediatric solid tumors. Pediatric Hematology and Oncology, 30, 655–661.
To compare the effectiveness, toxicities, and cost of two granulocyte colony-stimulating factor (G-CSF) preparations
Patients were randomized to two group—one receiving filgrastim and one receiving lenograstim after one chemotherapy treatment cycle. Patients then crossed over to the opposite preparation for the next chemotherapy cycle.
Febrile neutropenia was defined as absolute neutrophil count less than .05x103 cells per µL and oral or axillary temperature above 38.3 degrees centigrade or 38.0 for more than one hour.
No differences were seen in treatments in febrile neutropenia, antibiotic use, rate of infection, use of platelet transfusions, or hospitalization. Cost was significantly lower with filgrastim (p = .002). No differences were seen between treatments in adverse effects. Bone pain was the most frequent side effect, with no significant differences between treatments
Findings suggest that efficacy and side effects of filgrastim and lenograstim are equivalent. Filgrastim use was less costly.
Findings show that both of these G-CSF formulations provide similar results but differ substantially in cost. Nurses can advocate for less costly alternatives for care according to patients’ financial situations. The main side effect for patients is bone pain, which needs to be addressed effectively.