{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T15:27:19Z","timestamp":1767626839714,"version":"3.40.3"},"reference-count":43,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,4,1]],"date-time":"2024-04-01T00:00:00Z","timestamp":1711929600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Recombinant human granulocyte colony\u2010stimulating factor (G\u2010CSF) administration in patients with cancer and coronavirus disease (COVID\u201019) remains controversial. Concerns exist that it may worsen COVID\u201019 outcomes by triggering an inflammatory cytokine storm, despite its common use for managing chemotherapy\u2010induced neutropenia (CIN) or febrile neutropenia post\u2010chemotherapy. Here, we determined whether prophylactic or therapeutic G\u2010CSF administration following chemotherapy exacerbates COVID\u201019 progression to severe\/critical conditions in breast cancer patients with COVID\u201019. Between December 2022 and February 2023, all 503 enrolled breast cancer patients had concurrent COVID\u201019 and received G\u2010CSF post\u2010chemotherapy, with most being vaccinated pre\u2010chemotherapy. We prospectively observed COVID\u201019\u2010related adverse outcomes, conducted association analyses, and subsequently performed Mendelian randomization (MR) analyses to validate the causal effect of genetically predicted G\u2010CSF or its associated granulocyte traits on COVID\u201019 adverse outcomes. Only 0.99% (5\/503) of breast cancer patients experienced COVID\u201019\u2010related hospitalization following prophylactic or therapeutic G\u2010CSF administration after chemotherapy. No mortality or progression to severe\/critical COVID\u201019 occurred after G\u2010CSF administration. Notably, no significant associations were observed between the application, dosage, or response to G\u2010CSF and COVID\u201019\u2010related hospitalization (all <jats:italic>p<\/jats:italic>\u2009&gt;.05). Similarly, the MR analyses showed no evidence of causality of genetically predicted G\u2010CSF or related granulocyte traits on COVID\u201019\u2010related hospitalization or COVID\u201019 severity (all <jats:italic>p<\/jats:italic>\u2009&gt;.05). There is insufficient evidence to substantiate the notion that the prophylactic or therapeutic administration of G\u2010CSF after chemotherapy for managing CIN in patients with breast cancer and COVID\u201019 would worsen COVID\u201019 outcomes, leading to severe or critical conditions, or even death, especially considering the context of COVID\u201019 vaccination.<\/jats:p>","DOI":"10.1002\/ijc.34914","type":"journal-article","created":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T05:19:50Z","timestamp":1712035190000},"page":"545-557","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Clinical outcomes of coronavirus disease in patients with breast cancer treated with granulocyte colony\u2010stimulating factor following chemotherapy: Triangulation of evidence using population\u2010based cohort and Mendelian randomization 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