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

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:

• Hematologic malignancy
• intensive care unit
• G-CSF
• neutropenia recovery
• acute respiratory failure
• propensity score

Acknowledgements

The authors thank Pr M. Resche-Rigon (Biostatistics department, Saint-Louis Teaching Hospital, Paris, France) for his help regarding statistics.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at https://doi.org/10.1080/10428194.2018.1516874.

Additional information

Funding

The study was supported by grant PHRC AOM 08235 from the French Ministry of Health (Ministère des Affaires Sociales et de la Santé).