Granulocyte colony-stimulating factor and respiratory status of critically ill neutropenic patients with hematologic malignancies. Issue 5 (16th April 2019)

• Record Type: Journal Article
• Authors: Mignard, Xavier; Biard, Lucie; Lemiale, Virginie; Mokart, Djamel; Pène, Frédéric; Kouatchet, Achille; Mayaux, Julien; Vincent, François; Nyunga, Martine; Bruneel, Fabrice; Rabbat, Antoine; Lebert, Christine; Perez, Pierre; Meert, Anne-Pascale; Benoit, Dominique; Hamidfar, Rebecca; Darmon, Michael; Azoulay, Elie; Zafrani, Lara
• Is Part Of: Leukemia & lymphoma. Volume 60:Issue 5(2019)
• Page Start: 1156
• Page End: 1163
• Publication Date: 2019-04-16
• Subjects: Hematologic malignancy -- intensive care unit -- G-CSF -- neutropenia recovery -- acute respiratory failure -- propensity score; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2018.1516874
• Languages: English
• ISSNs: 1042-8194

Abstract

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.