THE IN-VIVO EFFECT OF RECOMBINANT HUMAN GRANULOCYTE-COLONY-STIMULATING FACTOR IN NEUTROPENIC NEONATES WITH SEPSIS

The effects of recombinant granulocyte-colony stimulating factor (rhG- CSF) in neonatal neutropenia with presumed sepsis, which has a poor pr ognosis, were investigated. The study involved 14 neonates with presum ed sepsis and neutropenia. Findings were compared with those from 24 h istorical controls. rhG-CSF (5 mu g/kg/day i.v. for 5 days) was admini stered immediately following diagnosis. Complete blood counts were obt ained before and 24, 48, 72, 96 and 120 h after initiation of treatmen t. Neutrophil storage pool (NSP) was assessed (in 4 patients) before a nd after treatment. Statistical analysis was performed using one way a nalysis of variance. Treatment led to an increase in absolute neutroph il count (ANC) levels in 13/14 patients. At the end of treatment, the mean ANC was higher than that of controls (P = 0.007). There was a mar ked increase in the NSP of between 32% and 65% (P = 0.005). There were two clinical failures, one of whom was considered to have died from h is underlying condition. There were no reports of clinical or haematol ogical toxicity during treatment or follow up.