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Using Granulocyte Colony-Stimulating Factor for Neutropenia During Neonatal Sepsis

Jeffrey C. Murray, MD; Kenneth L. McClain, MD, PhD; Mary E. Wearden, MD
Arch Pediatr Adolesc Med. 1994;148(7):764-766. doi:10.1001/archpedi.1994.02170070102021.
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The neonate is a relatively immunocompromised host. Deficiencies in both the neutrophilmacrophage phagocytic system and antibodymediated immunity contribute to the risk for bacterial sepsis, a life-threatening condition with a 20% to 75% mortality rate.1-3

Previous studies have suggested the benefit of granulocyte transfusions and intravenous gamma globulin in the treatment of neonatal sepsis.4,5 Recently, success using recombinant human granulocyte colony-stimulating factor (rhG-CSF) for chemotherapy-induced and congenital neutropenia6 has led to investigations using this hematopoietic cytokine during neonatal sepsis. Data from neonatal rat models demonstrate the effectiveness of rhG-CSF therapy during experimental sepsis.7-9 Results of preliminary biological studies of the efficacy and toxicity of rhG-CSF in human neonatal sepsis also appear favorable.10

We describe a premature neonate with Escherichia coli sepsis and neutropenia who was given rhG-CSF and responded with an increased neutrophil count and rapid resolution of sepsis.

Patient Report. A 1580-g male infant was


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