Granulocyte colony-stimulating factor and respiratory status of critically ill neutropenic patients with hematologic malignancies

Leuk Lymphoma. 2019 May;60(5):1156-1163. doi: 10.1080/10428194.2018.1516874. Epub 2018 Oct 2.

Abstract

In patients with hematologic malignancies, respiratory status may deteriorate during neutropenia recovery. This multicenter, observational study aims to evaluate granulocyte colony-stimulating factor (G-CSF) impact on respiratory status in critically ill neutropenic patients. Among 1011 critically ill patients with hematologic malignancies, 288 were neutropenic and included in this study. 201 (70%) did not receive G-CSF at day 1 or 2. After propensity score matching for the probability of receiving G-CSF at day 1 or 2, there was no association between G-CSF and respiratory deterioration at day 14 (OR =1.19; 95%CI (0.57-2.51); p = .64). Additional sensitivity analysis in patients admitted for acute respiratory failure showed similar results (OR =1.34; 95%CI (0.5-3.59); p = .57). Among patients who recovered from neutropenia, 75% experienced respiratory deterioration during neutropenia recovery. This study confirms that neutropenia recovery is a situation at risk of respiratory deterioration. However, whether G-CSF is an aggravating factor cannot be supported by our results.

Keywords: G-CSF; Hematologic malignancy; acute respiratory failure; intensive care unit; neutropenia recovery; propensity score.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Critical Illness*
  • Female
  • Granulocyte Colony-Stimulating Factor / administration & dosage
  • Granulocyte Colony-Stimulating Factor / adverse effects
  • Granulocyte Colony-Stimulating Factor / therapeutic use*
  • Hematologic Neoplasms / complications*
  • Hematologic Neoplasms / diagnosis
  • Humans
  • Intensive Care Units
  • Leukocyte Count
  • Male
  • Middle Aged
  • Neutropenia / diagnosis
  • Neutropenia / drug therapy*
  • Neutropenia / etiology*
  • Neutropenia / mortality
  • Propensity Score
  • Respiration / drug effects*
  • Respiratory Distress Syndrome / diagnosis
  • Respiratory Distress Syndrome / etiology
  • Respiratory Distress Syndrome / mortality
  • Respiratory Distress Syndrome / therapy
  • Respiratory Function Tests
  • Treatment Outcome

Substances

  • Granulocyte Colony-Stimulating Factor