Transient effect of granulocyte colony-stimulating factor in allo-immune neonatal neutropenia.
The effect of recombinant human granulocyte colony-stimulating factor (rhG-CSF) administration at 10 microg/kg/day for 15-30 min over 3 consecutive days in 3 preterm neonates with allo-immune neonatal neutropenia (ANN) is reported. Patients 1 and 2 had antibodies against antigen NA2, while patient 3 had antibodies against NA1. All neonates developed a rapid increase in absolute neutrophil count which reached the normal range within 48 h (from 75-640/mm(3) to 2,520-4,700/mm(3)). However, 23-25 days later, all 3 neonates relapsed into a second phase of severe neutropenia (408-870/mm(3)). Antibodies against neutrophil antigens were still positive during this period. This second-phase neutropenia persisted for 20-30 days and resolved spontaneously. It may be possible that when rhG-CSF is administered within a short time after birth in neonates with ANN, its effect is exhausted before the concentration of circulating antibodies decreases, with the result that a second phase of neutropenia can be expected.
Girlando
P
P
Division of Neonatology, Department of Paediatrics, Catholic University of the Sacred Heart, Rome, Italy. catneo@rm.unicatt.it
Zuppa
A A
AA
Romagnoli
C
C
Tortorolo
G
G
D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007518:Isoantibodies / Q000097:blood; D007519:Isoantigens / Q000276:immunology; D007958:Leukocyte Count; D008297:Male; D009503:Neutropenia / Q000188:drug therapy / Q000276:immunology*; D009504:Neutrophils / Q000276:immunology; D011994:Recombinant Proteins
D007518:Isoantibodies; D007519:Isoantigens; D011994:Recombinant Proteins; C067704:neutrophil-specific antigen NA1, human; C072753:neutrophil-specific antigen NA2; D016179:Granulocyte Colony-Stimulating Factor