Abstract
In adults and children, the duration of chemotherapy-induced neutropenia and associated complications has decreased because of the prophylactic use of granulocyte colony-stimulating factors (G-CSFs). Biosimilar G-CSFs can play an important role in reducing treatment costs in daily practice. However, some concerns regarding the efficacy and safety of new biosimilar products exist among clinicians. This study compared the efficacy and safety of original and biosimilar filgrastims for the prophylaxis of chemotherapy-induced neutropenia in children. Thirty children receiving myelosuppressive chemotherapy were enrolled in this study. Filgrastims (5 μg/kg/day) were subcutaneously administered in Group A (biosimilar, Leucostim®; Dem İlaç) and Group B (original drug, Neupogen®; Roche). Hemoglobin, white blood cell (WBC) count, platelet count, transfusion requirements, duration of hospitalization, and frequency and duration of adverse events including fever, neutropenia, and mucositis were evaluated following 25 treatment cycles in both groups. The hemoglobin value, WBC count, and platelet count on days 1, 5, and 10, and the red blood cell and platelet transfusion requirements, frequency, duration, and severity of mucositis, and durations of fever, febrile neutropenia, and hospitalization were similar in both groups. Although the mean WBC counts on days 1 and 5 were lower in Group A, the difference was statistically insignificant. The biosimilar filgrastim, Leucostim, is as effective and safe as the original drug for prophylaxis of chemotherapy-induced neutropenia in children.
Highlights
Intensified chemotherapeutic regimens cause many adverse effects, including prolonged and severe neutropenia, in addition to high rates of survival in childhood cancers
The hemoglobin value, white blood cell (WBC) count, and platelet count on days 1, 5, and 10, and the red blood cell and platelet transfusion requirements, frequency, duration, and severity of mucositis, and durations of fever, febrile neutropenia, and hospitalization were similar in both groups
The mean WBC counts on days 1 and 5 were lower in Group A, the difference was statistically insignificant
Summary
Intensified chemotherapeutic regimens cause many adverse effects, including prolonged and severe neutropenia, in addition to high rates of survival in childhood cancers. Neutropenia and subsequent infections increase hospitalization, mortality, and medical costs [1,2,3,4,5]. Granulocyte colony-stimulating factors (G-CSFs), which promote the proliferation, differentiation, and activation of neutrophils in the bone marrow, are widely used to prevent neutropenic complications in adults and children. The prophylactic use of G-CSFs reduces the duration of neutropenia and associated complications following chemotherapy [6, 7]. Biosimilar G-CSFs are copies of the original biological agent. They are increasingly being used in daily practice and can play a significant role in reducing costs [8, 9]. Concerns about the efficacy and safety of the new biosimilar products, which are not chemically identical to the original drugs, exist among clinicians
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