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Robert L. Roberts, MD, PhD; Cynthia M. Szelc, MD; Steven M. Scates, MD; Maria T. Boyd, RN, MN; Ken M. Soderstrom; Mark W. Davis, MS; John A. Glaspy, MD

Am J Dis Child. 1991;145(7):804-807.

Abstract
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 x 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 x10⁹/L within 2 weeks. The dosage was lowered and the absolute neutrophil counts were maintained at 8 to 12 x 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 2x10⁹/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)

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).

Footnotes
Accepted for publication January 28, 1991.

Presented in part at the annual Society of Pediatric Research meeting, Anaheim, Calif, May 10, 1990.

Reprint requests to the Department of Pediatrics, 22-387 MDCC, UCLA Medical Center, Los Angeles, CA 90024 (Dr Roberts).

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