Prophylactic PEG-rhG-CSF Reduces Febrile Neutropenia in Pediatric Hematological Malignancies Compared with Daily rhG-CSF
In brief
Single-dose PEG-G-CSF cuts febrile neutropenia by 18% in children with blood cancers
In a randomized trial of 138 chemotherapy cycles, a single pegylated G-CSF dose lowered febrile neutropenia from 78% to 59% compared with daily short-acting G-CSF, without increasing adverse events. Recovery time, hospital stay and costs were similar, but larger studies are needed to confirm rare safety differences.
- Journal
- Cancers (Q1)
- Published
- 9 July 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Xiao Zhang, Yang Fu, Hongsheng Wang, Xiaohua Zhu, Yi Yu, Ping Cao, et al.
- PMID
- 42512281
- DOI
- 10.3390/cancers18142214
Why clinicians should know about it
- Picked for Hematology (top studies of the week, 2 August 2026).
- Picked for Pediatrics and Child Health (top studies of the week, 2 August 2026).
- Picked for Oncology and Radiation Oncology (top studies of the week, 2 August 2026): Phase III RCT, PEG‑G‑CSF reduces febrile neutropenia in pediatric malignancies
Abstract
Background: Febrile neutropenia (FN) is a major complication of chemotherapy in pediatric hematological malignancies. This study compared the efficacy and safety of prophylactic pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) versus daily short-acting recombinant human granulocyte colony-stimulating factor (rhG-CSF). Methods: This single-center, open-label, randomized controlled trial was conducted at a tertiary children's hospital in China. Pediatric patients (<18 years) with confirmed hematological malignancies (leukemia or lymphoma) were enrolled. A total of 138 chemotherapy cycles were randomized 2:1 to receive either a single dose of PEG-rhG-CSF (100 μg/kg, n = 86 cycles) or daily short-acting rhG-CSF (5 μg/kg/day, n = 45 cycles) after chemotherapy. The primary endpoint was FN incidence. Secondary endpoints included neutropenia incidence, FN duration, time to neutrophil recovery, blood product transfusions, hospital stay, and costs. Safety was assessed by monitoring adverse events (AEs) graded according to NCI CTCAE version 4.03. Results: Baseline characteristics were comparable between groups. PEG-rhG-CSF significantly reduced the incidence of FN (59.3% vs. 77.7%, OR 0.42 (0.18-0.97), p = 0.046) compared to daily rhG-CSF. The median time to neutrophil recovery was 9.8 days (95% CI: 8.1-10.7) in the PEG-rhG-CSF group and 10.3 days (95% CI: 8.6-11.1) in the control group (p = 0.45). No significant differences were observed in FN duration, transfusions, hospital stay, or costs. Subgroup analyses showed PEG-rhG-CSF significantly reduced FN in non-Hodgkin lymphoma (57.4% vs. 83.3%, OR 0.27 (0.08-0.89), p = 0.032). A total of 12 AEs (9.9% overall, mainly bone pain) were observed, with no significant difference between groups and no infection-related deaths. Conclusions: In this single-center, open-label trial, prophylactic single-dose PEG-rhG-CSF was associated with a lower incidence of FN compared to daily short-acting rhG-CSF. Safety profiles appeared broadly similar, but the sample size was insufficient to detect rare differences.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.