Journal article
Outcomes of granulocyte colony-stimulating factor use in pediatric kidney transplant recipients: A Pediatric Nephrology Research Consortium study
Pediatric transplantation, Vol.26(3), pp.e14202-n/a
12/29/2021
DOI: 10.1111/petr.14202
PMID: 34967072
Abstract
Background Neutropenia is common in the first year after pediatric kidney transplant and is associated with an increased risk of infection, allograft loss, and death. Granulocyte colony-stimulating factor (G-CSF) increases neutrophil production, but its use in pediatric solid organ transplant recipients remains largely undescribed. Methods We performed a multicenter retrospective cohort study of children with neutropenia within the first 180 days after kidney transplant. Multivariable linear regression and Poisson regression were used to assess duration of neutropenia and incidence of hospitalization, infection, and rejection. Results Of 341 neutropenic patients, 83 received G-CSF during their first episode of neutropenia. Median dose of G-CSF was 5 mcg/kg for 3 (IQR 2-7) doses. G-CSF use was associated with transplant center, induction immunosuppression, steroid-free maintenance immunosuppression, hospitalization, and decreases in mycophenolate mofetil, valganciclovir, and trimethoprim-sulfamethoxazole dosing. Absolute neutrophil count nadir was also significantly lower among those treated with G-CSF. G-CSF use was not associated with a shorter duration of neutropenia (p = .313) and was associated with a higher rate of neutropenia relapse (p = .002) in adjusted analysis. G-CSF use was associated with a decreased risk of hospitalization (aIRR 0.25 (95%CI 0.12-0.53) p < .001) but there was no association with incidence of bacterial infection or rejection within 90 days of neutropenic episode. Conclusion G-CSF use for neutropenia in pediatric kidney transplant recipients did not shorten the overall duration of neutropenia but was associated with lower risk of hospitalization. Prospective studies are needed to determine which patients may benefit from G-CSF treatment.
Details
- Title: Subtitle
- Outcomes of granulocyte colony-stimulating factor use in pediatric kidney transplant recipients: A Pediatric Nephrology Research Consortium study
- Creators
- Rachel M. Engen - Northwestern UniversityPatricia L. Weng - University of California, Los AngelesWeiwen Shih - University of Michigan–Ann ArborHiren P. Patel - The Ohio State UniversityKelsey Richardson - Oregon Health & Science UniversityShauna L. Dowdrick - Penn State Milton S. Hershey Medical CenterIsa F. Ashoor - Louisiana State University Health Sciences Center New OrleansJason Misurac - Roy J. and Lucille A. Carver College of MedicineAvram Z. Traum - Harvard UniversityMichael G. Semanik - University of Wisconsin–MadisonNamarata G. Jain - Columbia UniversityRajasree Sreedharan - Medical College of Wisconsin
- Resource Type
- Journal article
- Publication Details
- Pediatric transplantation, Vol.26(3), pp.e14202-n/a
- Publisher
- Wiley
- DOI
- 10.1111/petr.14202
- PMID
- 34967072
- ISSN
- 1397-3142
- eISSN
- 1399-3046
- Number of pages
- 8
- Grant note
- Clinical and Translational Science Award (CTSA); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) UL1TR001422 / National Institutes of Health; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA
- Language
- English
- Date published
- 12/29/2021
- Academic Unit
- Nephrology, Dialysis and Transplantation; Stead Family Department of Pediatrics
- Record Identifier
- 9984354051902771
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