Hematopoietic colony-stimulating factors for neutropenic patients in the ICU

Objective: To assess whether adjunct hematopoietic colony-stimulating factor (H-CSF) accelerates neutrophil recovery and improves survival. Design: A retrospective study. Setting: Medical/surgical intensive care unit (ICU). Patients: 30 neutropenic patients admitted to the ICU and treated with H-CSF Controls were the preceding 30 neutropenic patients not treated with H-CSF Measurements and results: Patient admission characteristics were reviewed. Endpoints were neutrophil recovery (> 1.0 x 10(9)/l), length of ICU stay and survival. Depth and duration of neutropenia (0.267 +/- 0.04 x 10(9)/l for 12 +/- 1.7 days vs 0.293 +/- 0.05 x 10(9)/l for 15 +/- 1.9 days; p = 0.67 and 0.21), and the Acute Physiology and Chronic Health Evaluation II and organ system failure scores were similar. Systemic candidiasis was lower in the H-CSF group (20 vs 3 %; p > 0.05). In 11 (36.6 %) and 10 (33.3 %) patients neutrophil count recovered (> 1.0 x 10(9)/l); H-CSF did not reduce the duration of neutropenia (7.8 +/- 1.4 vs 5.7 +/- 1.3 days; p = 0.28), the length of ICU stay (7.8 +/- 1.1 vs 8.9 +/- 1.5 days; p = 0.55) or improve survival (23 vs 10 %; p = 0.168). Conclusion: H-CSF for treatment of neutropenia in patients admitted to the ICU did not accelerate neutrophil recovery or improve survival.