Notropenik atesli cocuklarda granulosit-koloni stimulan faktor (G-CSF) ve intravenoz immunoglobulinin etkinligi

In this study, effects of G-CSF and IVIG on the treatment of neutropenic fever in 55 pediatric malignancy cases were evaluated. For this purpose, 70 neutropenic fever episodes of these patients were treated with empirical antibiotic treatment plus G-CSF and/or IVIG. Study groups were treated as follows: group I, antibiotics (n:22); group II, antibiotics + G-CSF (n:22); group III, antibiotics + G-CSF + IVIG (n:12); group IV, antibiotics + IVIG (n:14). Ceftazidime and amikasin were started empirically in each patient. If the fever continued for three days, vancomycin was added. If the fever persisted for five to seven days despite these measures amphotericin B was added to the treatment. G-CSF was given subcutaneously (5 μg/kg/days) until neutrophil counts reached 1500/mm³, IVIG was given at 700 mg/kg in one dose only. There were no significant differences in the distribution of age, sex, erythrocyte sedimentation rate, leukocyte and neutrophil count, CRP, and immunoglobulin levels between the study groups. Effects of the treatment on mortality rates were also similar. Therefore, it was concluded that G-CSF and IVIG should not be given to neutropenic patients routinely.