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Single-center, real-world experience with granulocyte colony-stimulating factor for management of leukopenia following kidney transplantation.
- Source :
-
Clinical transplantation [Clin Transplant] 2019 Jun; Vol. 33 (6), pp. e13541. Date of Electronic Publication: 2019 Apr 11. - Publication Year :
- 2019
-
Abstract
- Background: Leukopenia is a frequent complication following kidney transplantation. Granulocyte colony-stimulating factor (G-CSF) has been used to accelerate white blood cell (WBC) count recovery; however, published experience in kidney transplantation is limited.<br />Methods: We retrospectively reviewed our kidney transplant recipients from January 2012 to September 2016 with a G-CSF order to evaluate leukopenia management (defined as WBC <3000 cells/μL).<br />Results: Thirty-six recipients were included. On average, G-CSF treatment began at 98 ± 38 days. At G-CSF initiation, mean WBC count was 1240 ± 420 cells/μL and absolute neutrophil count (ANC) was 653 ± 368 cells/μL. Mean G-CSF dose was 4.6 ± 1.2 mcg/kg/dose (total 11.8 ± 9.0 mcg/kg), 77.8% of recipients were prescribed G-CSF as outpatients, and overall, median time to WBC count recovery was 9 (IQR 4-14) days. Changes in immunosuppression and prophylaxis regimens for leukopenia were also common. Within 1 month following leukopenia onset, no patients experienced acute rejection and 5 (14%) developed infection requiring hospitalization or opportunistic infection.<br />Conclusion: In kidney recipients with leukopenia, G-CSF may be helpful to achieve WBC count recovery in addition to changes in immunosuppression and prophylaxis medications. Prospective, randomized data are still needed to determine optimal G-CSF dosing in this population.<br /> (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Subjects :
- Disease Management
Female
Follow-Up Studies
Humans
Leukopenia etiology
Leukopenia pathology
Male
Middle Aged
Prognosis
Retrospective Studies
Risk Factors
Granulocyte Colony-Stimulating Factor administration & dosage
Kidney Failure, Chronic surgery
Kidney Transplantation adverse effects
Leukopenia drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1399-0012
- Volume :
- 33
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Clinical transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 30887581
- Full Text :
- https://doi.org/10.1111/ctr.13541