Advertisement
Original report| Volume 3, ISSUE 2, P70-75, 1999

Outcomes of granulocyte colony-stimulating factor or granulocyte-macrophage colony-stimulating factor use in neutropenic patients infected with human immunodeficiency virus

Open ArchiveDOI:https://doi.org/10.1016/S1201-9712(99)90012-7
Outcomes of granulocyte colony-stimulating factor or granulocyte-macrophage colony-stimulating factor use in neutropenic patients infected with human immunodeficiency virus
Previous ArticlePost mass-immunization measles outbreak in Taoyuan county, Taiwan: Dynamics of transmission, vaccine effectiveness, and herd immunity
Next ArticleBiomolecular techniques to detect Pneumocystis carinii f. sp. hominis pneumonia in patients with acquired immunodeficiency syndrome
      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Objective: To characterize the effects of granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage colony-stimulating factor (GM-CSF) on clinical outcomes in neutropenic HIV-infected patients, by means of a retrospective cohort study at an urban teaching hospital.
      Method: Data were reviewed from all patients discharged between January 1, 1996, and August 31, 1997, with human immunodeficiency virus and neutropenia (absolute neutrophil count (ANC) <1000 cells/μL), with outcome measures of length of stay, infectious complications, and survival to discharge.
      Results: Of the 228 discharged patients who met selection criteria, 71 had received G-CSF or GM-CSF; 157 controls had not. Cases had lower CD4+ cell counts (30 vs. 54 cells/μL; P = 0.017) and lower nadir ANCs (372 vs. 579 cells/μL; P < 0.001). Granulocyte-CSF or GM-CSF usage was not associated with the frequency of site-related infections, fever, or sepsis (all P > 0.20). No difference was found in duration of hospitalization (23 vs. 21 days; P > 0.20). In a logistic regression model for survival to discharge, higher nadir ANC and CSF use were independently associated with improved survival (P = 0.034 and P = 0.026, respectively).
      Conclusion: Use of G-CSF or GM-CSF was associated with improved survival to discharge among hospitalized HIV-infected patients with neutropenia.

      Keywords

      References

        • Murphy M.F.
        • Metcalfe P.
        • Waters A.H.
        • et al.
        Incidence and mechanism of neutropenia and thrombocytopenia in patients with human immunodeficiency virus infection.
        Br J Haematol. 1987; 66: 337-340
        • Hughes W.T.
        • Armstrong D.
        • Bodey G.P.
        • et al.
        Guidelines for the use of antimicrobial agents in neutropenic patients with unexplained fever: a statement by the Infectious Diseases Society of America.
        J Infect Dis. 1991; 162: 381-396
        • Chanock S.
        Evolving risk factors for infectious complications of cancer therapy.
        Hematol Oncol Clin North Am. 1993; 7: 771-793
        • Farber B.F.
        • Lesser M.
        • Kaplan M.H.
        • et al.
        Clinical significance of neutropenia in patients with human immunodeficiency virus infection.
        Infect Control Hosp Epidemiol. 1991; 12: 429-434
        • Whimbey E.
        • Gold J.W.M.
        • Polsky B.
        • et al.
        Bacteremia and fungemia in patients with the acquired immunodeficiency syndrome.
        Ann Intern Med. 1986; 104: 511-514
        • Hambleton J.
        • Aragon T.
        • Modin G.
        • et al.
        Outcome for hospitalized patients with fever and neutropenia who are infected with the human immunodeficiency virus.
        Clin Infect Dis. 1995; 20: 363-371
        • Moore R.D.
        • Keruly J.C.
        • Chaisson R.E.
        Neutropenia and bacterial infection in acquired immunodeficiency syndrome.
        Arch Intern Med. 1995; 155: 1965-1970
        • Shaunak S.
        • Bartlett J.A.
        Zidovudine-induced neutropenia: Are we too cautious?.
        Lancet. 1989; 2: 91-92
        • Tumbarello M.
        • Tacconelli E.
        • Caponera S.
        • et al.
        Impact of bacteremia on HIV infection: nine years' experience in a large Italian university hospital.
        J Infect. 1995; 31: 123-131
        • Lieschke G.J.
        • Burgess A.W.
        Granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor.
        N Engl J Med. 1992; 327: 99-106
        • Hartmann L.C.
        • Tschetter L.K.
        • Habermann T.M.
        • et al.
        G-CSF in severe chemotherapy induced afebrile neutropenia.
        N Engl J Med. 1997; 336: 1776-1780
        • Maher D.W.
        • Lieschke G.J.
        • Green M.
        • et al.
        Filgrastim in patients with chemotherapy-induced febrile neutropenia: a doubleblind, placebo-controlled trial.
        Ann Intern Med. 1994; 121: 492-501
        • Anaissie E.
        • Vartivarian S.
        • Bodey G.P.
        • et al.
        Randomized comparison between antibiotics alone and antibiotics plus GMCSF (Escherichia coli-derived) in cancer patients with fever and neutropenia.
        Am J Med. 1996; 100: 17-23
        • Dombret H.
        • Chastang C.
        • Fenaus P.
        • et al.
        A controlled study of recombinant human-granulocyte colony-stimulating factor in elderly patients after treatment for acute myelogenous leukemia.
        N Engl J Med. 1995; 332: 1678-1683
        • Ottmann O.G.
        • Hoelzer D.
        • Gracien E.
        • et al.
        Concomitant granulocyte colony-stimulating factor and induction chemoradiotherapy in adult acute lymphoblastic leukemia: a randomized phase III trial.
        Blood. 1995; 86: 444-450
        • American Society of Clinical Oncology
        American Society of Clinical Oncology recommendations for the use of hematopoietic colony-stimulating factors: evidence-based clinical practice guidelines.
        J Clin Oncol. 1994; 12: 2471-2508
        • American Society of Clinical Oncology
        Update of recommendations for the use of hematopoietic colony-stimulating factors: evidence-based clinical practice guidelines.
        J Clin Oncol. 1996; 14: 1957-1960
        • Hermans P.
        Clinical use of haematological growth factors in patients with human immunodeficiency virus (HIV-1) infection.
        Biomed Pharmacother. 1994; 48: 69-72
        • Miles S.A.
        The use of haematopoietic growth factors in HIV infection and AIDS-related malignancies.
        Cancer Invest. 1991; 9: 229-238
        • Kimura S.
        • Matsuda J.
        • Ikematsu S.
        • et al.
        Efficacy of recombinant G-CSF on neutropenia in patients with AIDS.
        AIDS. 1990; 4: 1251-1255
        • Kuritzkes D.
        • Parenti D.
        • Ward D.J.
        • et al.
        Filgrastim prevents severe neutropenia and reduces infective morbidity in patients with advanced HIV infection: results of a randomized, multicenter, controlled trial.
        AIDS. 1998; 12: 65-74
        • Keiser P.
        • Rademacher S.
        • Smith J.
        • et al.
        G-CSF use is associated with decreased bacteremia and increased survival in neutropenic HIV-infected patients.
        Am J Med. 1998; 104: 48-55
        • De Pauw B.E.
        • Deresinski S.C.
        • Feld R.
        • et al.
        Ceftazidime compared with piperacillin and tobramycin for the empiric treatment of fever in neutropenic patients with cancer.
        Ann Intern Med. 1994; 120: 834-944
      24. Report of the Task Force of Microbiology and Infectious Diseases. 6th ed. NIH Publication No. 92-3220. National Institute of Allergy and Infectious Diseases, Bethesda, MDApril 1992
        • Meynard J.L.
        • Guiguet M.
        • Arsac S.
        • et al.
        Frequency and risk factors of infectious complications in neutropenic patients infected with HIV.
        AIDS. 1997; 11: 955-998

      Article info

      Publication history

      Accepted: October 29, 1998
      Received: June 30, 1998

      Identification

      DOI: https://doi.org/10.1016/S1201-9712(99)90012-7

      Copyright

      © 1999 Published by Elsevier Inc.

      User license

      Elsevier user license |
      How you can reuse Information Icon
      Elsevier user license

      Permitted

      For non-commercial purposes:

      • Read, print & download
      • Text & data mine
      • Translate the article

      Not Permitted

      • Reuse portions or extracts from the article in other works
      • Redistribute or republish the final article
      • Sell or re-use for commercial purposes

      Elsevier's open access license policy

      ScienceDirect

      Access this article on ScienceDirect
      We use cookies to help provide and enhance our service and tailor content. To update your cookie settings, please visit the for this site.
      Copyright © 2023 Elsevier Inc. except certain content provided by third parties. The content on this site is intended for healthcare professionals.


      RELX