Descriptive Analysis of Filgrastim use in children in Quebec’s University Teaching Hospitals, Canada.

Ghislain Berard, Cathy Quirion, Chantal Guevremont, Jean-Francois Delisle,Elaine Pelletier, Nathalie Marcotte, Marie-Claude Michel, France Varin, Paul Farand, Raghu Rajan, Philippe Ovetchkine, Louise Deschesne, Daniel Froment, Monia Marzouki

CIUSSS de l’Estrie – CHUS, Sherbrooke, Canada, McGill University Health Centre, Montreal, Canada, Centre hospitalier universitaire Sainte-Justine, Montreal, Canada, CHU de Quebec Universite Laval, Que ´bec, Canada, Centre hospitalier de l’Universite de Montreal, Montre al, Canada, Programme de gestion therapeutique des medicaments, Canada

Background: Filgrastim use in primary prophylaxis of febrile neutropenia in children is generally guided by specific research protocols. Its use in febrile neutropenia treatment for this population is also common.

Objective/Purpose: Describe filgrastim use in the pediatric population.

Study Design/Methods: Retrospectively, 175 episodes of care in 148 patients who received filgrastim between 1 August 2014 and 31 July 2015 were chosen randomly and reviewed.

Results/Key findings: Filgrastim was used in 79 episodes for primary prophylaxis, 6 for secondary prophylaxis and 42 for febrile neutropenia. In all but four episodes of primary prophylaxis, filgrastim was given as part of a clinical study or a protocol identical to a closed study. All were for patients that received chemotherapy at high or moderate risk of febrile neutropenia. In the 42 episodes of febrile neutropenia, mean hospitalisation stay was 25.9 days and mean filgrastim use was 5.7 days. At least one factor for poor clinical outcome was identified in 30 of these episodes. Absolute neutrophil count was above 1.9 x 10e9/L in 14 episodes when filgrastim was stopped.

Conclusion/Recommendations: Tools to help clinicians with filgrastim prescription outside of clinical research protocols (pre-printed order, febrile neutropenia guidelines, standardised absolute neutrophil count for filgrastim discontinuation) should be developed to optimize its use.

Reference: Selected abstracts presented at the Canadian Association of Pharmacy in Oncology (CAPhO) Conference 2019 taking place from 25–28 April 2019, in Halifax, Nova Scotia.