TY - JOUR
T1 - Effectiveness of Granulocyte Colony-Stimulating Factor in Hospitalized Infants with Neutropenia
AU - Lee, Jin A.
AU - Sauer, Brooke
AU - Tuminski, William
AU - Cheong, Jiyu
AU - Fitz-Henley, John
AU - Mayers, Megan
AU - Ezuma-Igwe, Chidera
AU - Arnold, Christopher
AU - Hornik, Christoph P.
AU - Clark, Reese H.
AU - Benjamin, Daniel K.
AU - Smith, P. Brian
AU - Ericson, Jessica E.
N1 - Funding Information:
This work was funded under National Institute for Child Health and Human Development (NICHD) contract HHSN275201000003I for the Pediatric Trials Network and under NICHD award number 1R25-HD076475-01. Research reported in this publication was also supported by the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH) under award number UL1TR001117. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Dr. Hornik receives salary support for research from the National Center for Advancing Translational Sciences of the NIH (UL1TR001117). Dr. Benjamin receives support from the NIH (award 2K24HD058735-06, National Center for Advancing Translational Sciences award UL1TR001117, NICHD contract HHSN275201000003I, and National Institute of Allergy and Infectious Diseases contract HHSN272201500006I). Dr. Smith receives salary support for research from the NIH and the National Center for Advancing Translational Sciences of the NIH (UL1TR001117), the NICHD (HHSN275201000003I and 1R01-HD081044-01), and the Food and Drug Administration (1R18-D005292-01). Dr. Ericson receives support from the NICHD under award number 5T32HD060558. The other authors have no financial disclosures relevant to this article.
Publisher Copyright:
© Thieme Medical Publishers333 Seventh Avenue, New York, NY 10001, USA.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Objective The objective of this study was to determine the time to hematologic recovery and the incidence of secondary sepsis and mortality among neutropenic infants treated or not treated with granulocyte colony-stimulating factor (G-CSF). Study Design We identified all neutropenic infants discharged from 348 neonatal intensive care units from 1997 to 2012. Neutropenia was defined as an absolute neutrophil count ≤ 1,500/µL for ≥ 1 day during the first 120 days of life. Incidence of secondary sepsis and mortality and number of days required to reach an absolute neutrophil count > 1,500/µL for infants exposed to G-CSF were compared with those of unexposed infants. Results We identified 30,705 neutropenic infants, including 2,142 infants (7%) treated with G-CSF. Treated infants had a shorter adjusted time to hematologic recovery (hazard ratio: 1.36, 95% confidence interval [CI]: 1.30-1.44) and higher adjusted odds of secondary sepsis (odds ratio [OR]: 1.50, 95% CI: 1.20-1.87), death (OR: 1.33, 95% CI: 1.05-1.68), and the combined outcome of sepsis or death (OR: 1.41, 95% CI: 1.19-1.67) at day 14 compared with untreated infants. These differences persisted at day 28. Conclusion G-CSF treatment decreased the time to hematologic recovery but was associated with increased odds of secondary sepsis and mortality in neutropenic infants. G-CSF should not routinely be used for infants with neutropenia.
AB - Objective The objective of this study was to determine the time to hematologic recovery and the incidence of secondary sepsis and mortality among neutropenic infants treated or not treated with granulocyte colony-stimulating factor (G-CSF). Study Design We identified all neutropenic infants discharged from 348 neonatal intensive care units from 1997 to 2012. Neutropenia was defined as an absolute neutrophil count ≤ 1,500/µL for ≥ 1 day during the first 120 days of life. Incidence of secondary sepsis and mortality and number of days required to reach an absolute neutrophil count > 1,500/µL for infants exposed to G-CSF were compared with those of unexposed infants. Results We identified 30,705 neutropenic infants, including 2,142 infants (7%) treated with G-CSF. Treated infants had a shorter adjusted time to hematologic recovery (hazard ratio: 1.36, 95% confidence interval [CI]: 1.30-1.44) and higher adjusted odds of secondary sepsis (odds ratio [OR]: 1.50, 95% CI: 1.20-1.87), death (OR: 1.33, 95% CI: 1.05-1.68), and the combined outcome of sepsis or death (OR: 1.41, 95% CI: 1.19-1.67) at day 14 compared with untreated infants. These differences persisted at day 28. Conclusion G-CSF treatment decreased the time to hematologic recovery but was associated with increased odds of secondary sepsis and mortality in neutropenic infants. G-CSF should not routinely be used for infants with neutropenia.
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U2 - 10.1055/s-0036-1593349
DO - 10.1055/s-0036-1593349
M3 - Article
C2 - 27649291
AN - SCOPUS:84988429312
SN - 0735-1631
VL - 34
SP - 458
EP - 464
JO - American Journal of Perinatology
JF - American Journal of Perinatology
IS - 5
M1 - 160204
ER -