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July 1991

Neutropenia in an Extremely Premature Infant Treated With Recombinant Human Granulocyte Colony-Stimulating Factor

Author Affiliations

From the Departments of Pediatrics (Drs Roberts and Szelc) and Medicine (Drs Scates and Glaspy and Ms Boyd), UCLA School of Medicine, Los Angeles, Calif, and Amgen Inc, Thousand Oaks, Calif (Messrs Soderstrom and Davis).

Am J Dis Child. 1991;145(7):804-807. doi:10.1001/archpedi.1991.02160070104030

Neutropenia in the newborn is often associated with sepsis, maternal hypertension, or prematurity. We describe a 654-g infant born at 30 weeks' gestation by cesarean section due to severe maternal hypertension. His course was complicated by five episodes of sepsis, including three with group B streptococcus. The results of hematologic and immunologic studies were normal except that absolute neutrophil counts were low (<1 × 109/L with intermittent increases during sepsis. Human recombinant granulocyte colony-stimulating factor administered subcutaneously (10 μg/kg per day initially) resulted in an absolute neutrophil count of greater than 30 ×109/L within 2 weeks. The dosage was lowered and the absolute neutrophil counts were maintained at 8 to 12 × 109/L with no further septic episodes. The human recombinant granulocyte colony-stimulating factor therapy was discontinued after 7 months, and the patient remained healthy with an absolute neutrophil count of greater than 2×109/L. Thus, treatment with human recombinant granulocyte colony-stimulating factor may be useful as a temporary measure for neonatal neutropenia associated with sepsis. A controlled, clinical trial is warranted.

(AJDC. 1991;145:808-812)

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