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Abstract
To evaluate the efficacy of granulocyte-macrophagecolony-stimulating factor(GM-CSF) in improving neutrophil counts and survival of neutropenicseptic neonates, the authors studied 8 neonates with gestational orpostconceptional ageat least 30 weeks; weight at least 1000 g; serious infection with concomitant neutropenia (absolute neutrophil count [ANC] < 3.0 10 9 / L) or leukopenia (white blood cell count < 5.0 10 9 / L) and anticipatedsurvival at least 48 h. Patients received 5 mu g/kg of GM-CSF intravenously for 5 consecutive days or until the ANC reached 20 10 9 / L. Clinical parameters and complete blood counts were monitored. Prestudy ANCs ranged from 0.05 to 2.7 10 9 /L. Four patients had positive blood cultures, 4 had necrotizing en terocolitis, and 1 was in septic shock. All patients had elevated C-reactiveprotein. All patients had resolution ofneutropenia and survived the septic episodes. The use of GM-CSF in these patients merits further exploration.