The Effect of Neutropenia and Filgrastim (G-CSF) in Cancer Patients With COVID-19 Infection.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
Allen ZhangYing Taur

Abstract

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 COVID-19 remains unknown. 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. In the setting of active COVID-19 infection, outpatient receipt of G-CSF led to an increased number of hospitalizations (HR: 3.54, 95% CI: 1.25-10.0, P value: 0.017). Furthermore, among inpatients, G-CSF...Continue Reading

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