Impact of colony-stimulating factor therapy on clinical outcome and frequency rate of nosocomial infections in intensive care unit neutropenic patients.
OBJECTIVE
To determine whether the use of recombinant human granulocyte colony-stimulating factor (G-CSF, filgrastim) reduces the mortality rate and the frequency rate of nosocomial infections in neutropenic patients requiring intensive care unit (ICU) admission.


METHODS
Retrospective consecutive case series analysis.


METHODS
Medical ICU of a teaching hospital.


METHODS
We compared two groups of patients, according to whether or not they received G-CSF. In the ICU, 28 leukopenic patients received filgrastim (5 microg of body weight per day intravenously). In all these patients, G-CSF was continued until recovery from leukopenia, defined as a leukocyte count >1,000/mm3. A total of 33 ICU leukopenic patients did not receive G-CSF. End points included leukocyte count, bone marrow recovery, frequency of ICU nosocomial infections (pneumonia, urinary tract, and catheter-related infections), and mortality rate.


RESULTS
There were no differences in number of patients who recovered from leukopenia or in whom blood leukocyte count increased. Nosocomial infections occurred in the same percentage in both groups. The percentage of patients who died was identical in both groups. The percentage of patients with and without filgrastim therapy who recovered from leukopenia but died, was 86% and 78%, respectively.


CONCLUSIONS
In the ICU, clinical outcome of neutropenic patients was not changed by G-CSF therapy. It is possible that G-CSF therapy may not be helpful in improving the ICU clinical outcome of neutropenic patients. Additional controlled studies designed to address this question are warranted.
Gruson
D
D
Medical Intensive Care Unit, University Hospital of Bordeaux, France.
Hilbert
G
G
Vargas
F
F
Valentino
R
R
Chene
G
G
Boiron
J M
JM
Reiffers
J
J
Gbikpi-Benissan
G
G
Cardinaud
J P
JP
D000328:Adult; D000368:Aged; D003428:Cross Infection / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007262:Infusions, Intravenous; D007362:Intensive Care Units; D007970:Leukopenia / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality; D011994:Recombinant Proteins; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim