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Effect of Recombinant Granulocyte Colony-Stimulating Factor on Blood Neutrophil Concentrations among Patients with “Idiopathic Neonatal Neutropenia”: A Randomized, Placebo-controlled Trial

Journal of Perinatology volume 23, pages 493–497 (2003)Cite this article

Abstract

OBJECTIVES: We previously described a severe, prolonged, idiopathic, but self-resolving, variety of neutropenia among preterm neonates. In the present study, we sought to assess the marrow neutrophil reserves of these patients by serially measuring blood neutrophils following the administration of recombinant granulocyte colony-stimulating factor (rG-CSF) or placebo.

STUDY DESIGN: Prospective, randomized trial of rG-CSF vs placebo for infants with “idiopathic neonatal neutropenia”.

RESULTS: During 36 consecutive months, 2407 neonates were admitted to the neonatal intensive care unit; 429 weighed less than 1500 g at birth, 14 of these were later diagnosed with “idiopathic neonatal neutropenia”; 10 were enrolled in this trial. The five rG-CSF recipients had an immediate, marked increase in blood neutrophil concentration, indicating adequate rG-CSF-mobilizable marrow neutrophil reserves. This effect persisted to day 5, but counts were not different from those of the five placebo recipients on days 12 and 15.

CONCLUSIONS: Patients with “idiopathic neonatal neutropenia” have a substantial rG-CSF-mobilizable marrow neutrophil reserve. On that basis, we speculate that this variety of neonatal neutropenia does not constitute a significant deficiency in antibacterial defense.

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References

  1. Juul SE, Calhoun DA, Christensen RD . “Idiopathic neutropenia” in very low birthweight infants. Acta Paediatr 1998;87:963–968.

    Article  CAS  Google Scholar 

  2. Omar SA, Salhadar A, Wooliever DE, Alsgaard PK . Late-onset neutropenia in very low birth weight infants. Pediatrics 2000;106E:55.

    Article  Google Scholar 

  3. Calhoun DA, Christensen RD, Edstrom CS, et al. Consistent approaches to procedures and practices in neonatal hematology. Clin Perinatol 2000;27:733–753.

    Article  CAS  Google Scholar 

  4. Bux J, Hofmann C, Welte K . Serum G-CSF levels are not increased in patients with antibody-induced neutropenia unless they are suffering from infectious diseases. Br J Haematol 1999;105:616–617.

    Article  CAS  Google Scholar 

  5. Bux J, Stroncek D . Human neutrophil antigens. Transfusion 2002;42:1523.

    Article  Google Scholar 

  6. Sola MC, Rimsza LM, Christensen RD . A bone marrow biopsy technique suitable for use in neonates. Br J Haematol 1999;107:458–460.

    Article  CAS  Google Scholar 

  7. al-Mulla ZS, Christensen RD . Neutropenia in the neonate. Clin Perinatol 1995;22:711–739.

    Article  CAS  Google Scholar 

  8. Welte K, Dale D . Pathophysiology and treatment of severe chronic neutropenia. Ann Hematol 1996;72:158–165.

    Article  CAS  Google Scholar 

  9. Welte K, Boxer LA . Severe chronic neutropenia: pathophysiology and therapy. Semin Hematol 1997;34:267–278.

    CAS  PubMed  Google Scholar 

  10. Zeidler C, Boxer L, Dale DC, Freedman MH, Kinsey S, Welte K . Management of Kostmann syndrome in the G-CSF era. Br J Haematol 2000;109:490–495.

    Article  CAS  Google Scholar 

  11. Bonilla MA, Dale D, Zeidler C, et al. Long-term safety of treatment with recombinant human granulocyte colony- stimulating factor (r-metHuG-CSF) in patients with severe congenital neutropenias. Br J Haematol 1994;88:723–730.

    Article  CAS  Google Scholar 

  12. Ades LC, Gedeon AK, Wilson MJ, et al. Barth syndrome: clinical features and confirmation of gene localization to distal Xq28. Am J Med Genet 1993;45:327–334.

    Article  CAS  Google Scholar 

  13. Calhoun DA, Christensen RD . Recent advances in the pathogenesis and treatment of nonimmune neutropenias in the neonate. Curr Opin Hematol 1998;5:37–41.

    Article  CAS  Google Scholar 

  14. Murray NA, Acolet D, Deane M, Price J, Roberts IA . Fetal marrow suppression after maternal chemotherapy for leukaemia. Arch Dis Child Fetal Neonatal Ed 1994;71:F209–F210.

    Article  CAS  Google Scholar 

  15. Morstyn G, Foote M, Nelson S . Clinical benefits of improving host defenses with rHuG-CSF. Ciba Found Symp 1997;204:78–85.

    CAS  PubMed  Google Scholar 

  16. Gilmore MM, Stroncek DF, Korones DN . Treatment of alloimmune neonatal neutropenia with granulocyte colony-stimulating factor. J Pediatr 1994;125:948–951.

    Article  CAS  Google Scholar 

  17. Rodwell RL, Gray PH, Taylor KM, Minchinton R . Granulocyte colony stimulating factor treatment for alloimmune neonatal neutropenia. Arch Dis Child Fetal Neonatal Ed 1996;75:F57–F58.

    Article  CAS  Google Scholar 

  18. Latini G, Del Vecchio A, Rosati E, Borzini P, Chirico G, Rondini G . Different responses to granulocyte colony-stimulating factor treatment in siblings with alloimmune neonatal neutropenia. Acta Paediatr 1999;88:1407–1409.

    Article  CAS  Google Scholar 

  19. Bux J, Behrens G, Jaeger G, Welte K . Diagnosis and clinical course of autoimmune neutropenia in infancy: analysis of 240 cases. Blood 1998;91:181–186.

    CAS  PubMed  Google Scholar 

  20. Corbacioglu S, Bux J, Konig A, Gabrilove JL, Welte K, Bussel JB . Serum granulocyte colony-stimulating factor levels are not increased in patients with autoimmune neutropenia of infancy. J Pediatr 2000;137:96–99.

    Article  CAS  Google Scholar 

  21. Kocherlakota P, La Gamma EF . Preliminary report: rhG-CSF may reduce the incidence of neonatal sepsis in prolonged preeclampsia-associated neutropenia. Pediatrics 1998;102:1107–1111.

    Article  CAS  Google Scholar 

  22. Makhlouf RA, Doron MW, Bose CL, Price WA, Stiles AD . Administration of granulocyte colony-stimulating factor to neutropenic low birth weight infants of mothers with preeclampsia. J Pediatr 1995;126:454–456.

    Article  CAS  Google Scholar 

  23. Xanthou M . Leukocyte blood picture in ill newborn babies. Arch Dis Child 1972;47:741–746.

    Article  CAS  Google Scholar 

  24. Manroe BL, Weinberg AG, Rosenfeld CR, Browne R . The neonatal blood count in health and disease. I. Reference values for neutrophilic cells. J Pediatr 1979;95:89–98.

    Article  CAS  Google Scholar 

  25. Mouzinho A, Rosenfeld CR, Sanchez PJ, Risser R . Revised reference ranges for circulating neutrophils in very-low-birth-weight neonates. Pediatrics 1994;94:76–82.

    CAS  Google Scholar 

  26. Baley JE, Stork EK, Warkentin PI, Shurin SB . Neonatal neutropenia. Clinical manifestations, cause, and outcome. Am J Dis Child 1988;142:1161–1166.

    Article  CAS  Google Scholar 

  27. Bishop CR, Rothstein G, Ashenbrucker HE, Athens JW . Leukokinetic studies. XIV. Blood neutrophil kinetics in chronic steady-state neutropenia. J Clin Invest 1971;50:1678–1689.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, University of Washington, WA, USA

    Sandra E Juul MD, PhD

  2. Department of Pediatrics, University of South Florida, FL, USA

    Robert D Christensen MD

Authors
  1. Sandra E Juul MD, PhD
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  2. Robert D Christensen MD
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This study was Supported by NIH RR00082.

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Juul, S., Christensen, R. Effect of Recombinant Granulocyte Colony-Stimulating Factor on Blood Neutrophil Concentrations among Patients with “Idiopathic Neonatal Neutropenia”: A Randomized, Placebo-controlled Trial. J Perinatol 23, 493–497 (2003). https://doi.org/10.1038/sj.jp.7210961

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  • DOI: https://doi.org/10.1038/sj.jp.7210961

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