Effect of granulocyte/colony-stimulating factor on the onset of the adult respiratory distress syndrome

To evaluate the effect of granulocyte/colony-stimulating factor (G-CSF) on the onset of the adult respiratory distress syndrome (ARDS), we investigate d whether the incidence of ARDS due to pulmonary infection differed between the G-CSF group which received chemotherapy with G-CSF and historical cont rols without G-CSF. We evaluated 132 patients with hematological malignancy in complete remission without any main organ dysfunction who had been trea ted between April 1983 and December 1997. We compared the incidence of ARDS due to pulmonary infection between those who received G-CSF and those who did not. There was no remarkable difference in the number of patients, gend er, age, or distribution of primary diseases between the two groups. The in tensity of chemotherapy was nor considered to significantly differ between the two groups, though the chemotherapy regimens administered differed slig htly. In the G-CSF group, the duration of neutropenia was significantly sho rter and the frequency of documented infection was significantly decreased. We could not find any relationship between ARDS due to pulmonary infection and any anticancer agent or antibiotics. There was no relationship between the kind of G-CSF and the incidence of ARDS due to pulmonary infection (pe r chemotherapy session; p > 0.10, per case; p > 0.30, chi(2) test). The inc idence of ARDS due to pulmonary infection per chemotherapy session was 4.21 %, and showed a higher tendency in the G-CSF group (p < 0.100, chi(2) test) . The incidence of ARDS due to pulmonary infection per case was 25.4% and w as significantly higher in the G-CSF group (p < 0.025, chi(2) test). The in cidence of ARDS due to pulmonary infection was higher in the G-CSF group th an in the controls, suggesting that G-CSF promotes the development of ARDS due to pulmonary infection.