Your browser doesn't support javascript.
The Effect of Neutropenia and Filgrastim (G-CSF) on Cancer Patients With Coronavirus Disease 2019 (COVID-19) Infection.
Zhang, Allen W; Morjaria, Sejal; Kaltsas, Anna; Hohl, Tobias M; Parameswaran, Rekha; Patel, Dhruvkumar; Zhou, Wei; Predmore, Jacqueline; Perez-Johnston, Rocio; Jee, Justin; Daniyan, Anthony F; Perales, Miguel-Angel; Taur, Ying.
  • Zhang AW; MD/PhD Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
  • Morjaria S; Infectious Disease, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Kaltsas A; Department of Medicine, Weill Cornell Medical College, New York, New York, USA.
  • Hohl TM; Infectious Disease, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Parameswaran R; Department of Medicine, Weill Cornell Medical College, New York, New York, USA.
  • Patel D; Infectious Disease, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Zhou W; Department of Medicine, Weill Cornell Medical College, New York, New York, USA.
  • Predmore J; Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Perez-Johnston R; Hematology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Jee J; Department of Quality and Safety, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Daniyan AF; Operation Excellence, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Perales MA; Advanced Practice Provider Department, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Taur Y; MD/PhD Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Clin Infect Dis ; 74(4): 567-574, 2022 03 01.
Article in English | MEDLINE | ID: covidwho-1699244
ABSTRACT

BACKGROUND:

Neutropenia is commonly encountered in cancer patients. Recombinant human granulocyte colony-stimulating factor (G-CSF, filgrastim), a cytokine that initiates proliferation and differentiation of mature granulocytes, is widely given to oncology patients to counteract neutropenia, reducing susceptibility to infection. However, the clinical impact of neutropenia and G-CSF use in cancer patients with coronavirus disease 2019 (COVID-19) remains unknown.

METHODS:

An observational cohort of 379 actively treated cancer patients with COVID-19 was assembled to investigate links between concurrent neutropenia and G-CSF administration on COVID-19-associated respiratory failure and death. These factors were encoded as time-dependent predictors in an extended Cox model, controlling for age and underlying cancer diagnosis. To determine whether the degree of granulocyte response to G-CSF affected outcomes, the degree of response to G-CSF, based on rise in absolute neutrophil count (ANC) 24 hours after growth factor administration, was also incorporated into a similar Cox model.

RESULTS:

In the setting of active COVID-19 infection, outpatient receipt of G-CSF led to an increased number of hospitalizations (hazard ratio [HR] 3.54, 95% confidence interval [CI] 1.25-10.0, P value .017). Furthermore, among inpatients, G-CSF administration was associated with increased need for high levels of oxygen supplementation and death (HR 3.56, 95% CI 1.19-10.2, P value .024). This effect was predominantly seen in patients that exhibited a high response to G-CSF based on their ANC increase post-G-CSF administration (HR 7.78, 95% CI 2.05-27.9, P value .004).

CONCLUSIONS:

The potential risks versus benefits of G-CSF administration should be considered in neutropenic cancer patients with COVID-19, because G-CSF administration may lead to worsening clinical and respiratory status.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / COVID-19 Drug Treatment / Neoplasms / Neutropenia Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / COVID-19 Drug Treatment / Neoplasms / Neutropenia Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Clin Infect Dis Journal subject: Communicable Diseases Year: 2022 Document Type: Article Affiliation country: Cid