Little benefit of G-CSF in preterm neonates

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Kuhn et al report on the results of a multicenter, randomized, placebo controlled trial of prophylactic recombinant granulocyte-colony stimulating factor (rG-CSF) in neutropenic preterm infants in France. Inclusion was strictly confined to infants with absolute neutrophil counts less than 1500 cells/mm³ on consecutive measurements over a 24-hour period. Three daily doses of rG-CSF or placebo were administered to 200 preterm infants with neutropenia. No differences were found in 4-week survival, 4-week rate of infection, or neutrophil count at one week. Modest increased survival without confirmed infection at a 2-week time point was found in subjects treated with rG-CSF (84%) versus placebo (71%) (P = .03).

An important finding in this study was the transient natural history of neutropenia in most preterm infants with the condition.

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