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Effectiveness of Granulocyte Colony-Stimulating Factor in Hospitalized Infants with Neutropenia.

Publication ,  Journal Article
Lee, JA; Sauer, B; Tuminski, W; Cheong, J; Fitz-Henley, J; Mayers, M; Ezuma-Igwe, C; Arnold, C; Hornik, CP; Clark, RH; Benjamin, DK; Smith, PB ...
Published in: Am J Perinatol
April 2017

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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Published In

Am J Perinatol

DOI

EISSN

1098-8785

Publication Date

April 2017

Volume

34

Issue

5

Start / End Page

458 / 464

Location

United States

Related Subject Headings

  • Time Factors
  • Sepsis
  • Obstetrics & Reproductive Medicine
  • Neutrophils
  • Neutropenia
  • Male
  • Leukocyte Count
  • Infant, Newborn
  • Infant
  • Incidence
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lee, J. A., Sauer, B., Tuminski, W., Cheong, J., Fitz-Henley, J., Mayers, M., … Best Pharmaceuticals for Children Act—Pediatric Trials Network Steering Committee, . (2017). Effectiveness of Granulocyte Colony-Stimulating Factor in Hospitalized Infants with Neutropenia. Am J Perinatol, 34(5), 458–464. https://doi.org/10.1055/s-0036-1593349
Lee, Jin A., Brooke Sauer, William Tuminski, Jiyu Cheong, John Fitz-Henley, Megan Mayers, Chidera Ezuma-Igwe, et al. “Effectiveness of Granulocyte Colony-Stimulating Factor in Hospitalized Infants with Neutropenia.Am J Perinatol 34, no. 5 (April 2017): 458–64. https://doi.org/10.1055/s-0036-1593349.
Lee JA, Sauer B, Tuminski W, Cheong J, Fitz-Henley J, Mayers M, et al. Effectiveness of Granulocyte Colony-Stimulating Factor in Hospitalized Infants with Neutropenia. Am J Perinatol. 2017 Apr;34(5):458–64.
Lee, Jin A., et al. “Effectiveness of Granulocyte Colony-Stimulating Factor in Hospitalized Infants with Neutropenia.Am J Perinatol, vol. 34, no. 5, Apr. 2017, pp. 458–64. Pubmed, doi:10.1055/s-0036-1593349.
Lee JA, Sauer B, Tuminski W, Cheong J, Fitz-Henley J, Mayers M, Ezuma-Igwe C, Arnold C, Hornik CP, Clark RH, Benjamin DK, Smith PB, Ericson JE, Best Pharmaceuticals for Children Act—Pediatric Trials Network Steering Committee. Effectiveness of Granulocyte Colony-Stimulating Factor in Hospitalized Infants with Neutropenia. Am J Perinatol. 2017 Apr;34(5):458–464.
Journal cover image

Published In

Am J Perinatol

DOI

EISSN

1098-8785

Publication Date

April 2017

Volume

34

Issue

5

Start / End Page

458 / 464

Location

United States

Related Subject Headings

  • Time Factors
  • Sepsis
  • Obstetrics & Reproductive Medicine
  • Neutrophils
  • Neutropenia
  • Male
  • Leukocyte Count
  • Infant, Newborn
  • Infant
  • Incidence