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Granulocyte colony-stimulating factor and respiratory status of critically ill neutropenic patients with hematologic malignancies

par Mignard, Xavier;Biard, Lucie;Lemiale, Virginie;Mokart, Djamel;Pène, Frédéric;Kouatchet, Achille;Mayaux, Julien;Vincent, François;Nyunga, Martine;Bruneel, Fabrice;Rabbat, Antoine;Lebert, Christine;Perez, Pierre;Meert, Anne-Pascale ;Benoit, Dominique;Hamidfar, Rébecca;Darmon, Michael;Azoulay, Elie;Zafrani, Lara
Référence Leukemia & lymphoma, 60, 5, page (1156-1163)
Publication Publié, 2019-04-01

Article révisé par les pairs

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Résumé :

In patients with hematologic malignancies, respiratory status may deteriorate during neutropenia recovery. This multicenter, observational study aims to evaluate granulocyte colony-stimulating factor (G-CSF) impact on respiratory status in critically ill neutropenic patients. Among 1011 critically ill patients with hematologic malignancies, 288 were neutropenic and included in this study. 201 (70%) did not receive G-CSF at day 1 or 2. After propensity score matching for the probability of receiving G-CSF at day 1 or 2, there was no association between G-CSF and respiratory deterioration at day 14 (OR =1.19; 95%CI (0.57–2.51); p =.64). Additional sensitivity analysis in patients admitted for acute respiratory failure showed similar results (OR =1.34; 95%CI (0.5–3.59); p =.57). Among patients who recovered from neutropenia, 75% experienced respiratory deterioration during neutropenia recovery. This study confirms that neutropenia recovery is a situation at risk of respiratory deterioration. However, whether G-CSF is an aggravating factor cannot be supported by our results.