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

Jin A. Lee, Brooke Sauer, William Tuminski, Jiyu Cheong, John Fitz-Henley, Megan Mayers, Chidera Ezuma-Igwe, Christopher Arnold, Christoph P. Hornik, Reese H. Clark, Daniel K. Benjamin, P. Brian Smith, Jessica Ericson

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Article number160204
Pages (from-to)458-464
Number of pages7
JournalAmerican Journal of Perinatology
Volume34
Issue number5
DOIs
StatePublished - Apr 1 2017

Fingerprint

Granulocyte Colony-Stimulating Factor
Neutropenia
Sepsis
Confidence Intervals
Odds Ratio
Mortality
Neutrophils
Neonatal Intensive Care Units
Incidence

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Lee, Jin A. ; Sauer, Brooke ; Tuminski, William ; Cheong, Jiyu ; Fitz-Henley, John ; Mayers, Megan ; Ezuma-Igwe, Chidera ; Arnold, Christopher ; Hornik, Christoph P. ; Clark, Reese H. ; Benjamin, Daniel K. ; Smith, P. Brian ; Ericson, Jessica. / Effectiveness of Granulocyte Colony-Stimulating Factor in Hospitalized Infants with Neutropenia. In: American Journal of Perinatology. 2017 ; Vol. 34, No. 5. pp. 458-464.
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title = "Effectiveness of Granulocyte Colony-Stimulating Factor in Hospitalized Infants with Neutropenia",
abstract = "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.",
author = "Lee, {Jin A.} and Brooke Sauer and William Tuminski and Jiyu Cheong and John Fitz-Henley and Megan Mayers and Chidera Ezuma-Igwe and Christopher Arnold and Hornik, {Christoph P.} and Clark, {Reese H.} and Benjamin, {Daniel K.} and Smith, {P. Brian} and Jessica Ericson",
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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, J 2017, 'Effectiveness of Granulocyte Colony-Stimulating Factor in Hospitalized Infants with Neutropenia', American Journal of Perinatology, vol. 34, no. 5, 160204, pp. 458-464. https://doi.org/10.1055/s-0036-1593349

Effectiveness of Granulocyte Colony-Stimulating Factor in Hospitalized Infants with Neutropenia. / Lee, Jin A.; Sauer, Brooke; Tuminski, William; Cheong, Jiyu; Fitz-Henley, John; Mayers, Megan; Ezuma-Igwe, Chidera; Arnold, Christopher; Hornik, Christoph P.; Clark, Reese H.; Benjamin, Daniel K.; Smith, P. Brian; Ericson, Jessica.

In: American Journal of Perinatology, Vol. 34, No. 5, 160204, 01.04.2017, p. 458-464.

Research output: Contribution to journalArticle

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

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

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JF - American Journal of Perinatology

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