Prophylactic use of filgrastim with ABVD and BEACOPP chemotherapy regimens for Hodgkin lymphoma.

ABVD (doxorubicin/bleomycin/vinblastine/dacarbazine) and BEACOPP (bleomycin/etoposide/doxorubicin/cyclophosphamide/vincristine/procarbazine/prednisone) are the most widely used regimens for the treatment of patients with advanced stage Hodgkin lymphoma. Both regimens are associated with significant neutropenia. Maintaining the planned dose intensity is considered an important goal to achieve when using curative therapy. Therefore, prophylactic use of granulocyte colony-stimulating factor (G-CSF) is widely used to support these regimens and is mandatory to support BEACOPP-escalated and BEACOPP-14 to reduce toxicity and treatment delays. Recent retrospective studies are discussed which have reported using ABVD without G-CSF support. However, randomized studies are needed to clarify the role of primary prophylaxis with ABVD and BEACOPP-baseline regimens. Secondary prophylaxis should be considered in all patients, especially those who develop neutropenic fever.