{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T22:50:57Z","timestamp":1785883857983,"version":"3.56.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T00:00:00Z","timestamp":1623283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"NIH\/NCI) Cancer Center Support grant","award":["P30 CA008748"],"award-info":[{"award-number":["P30 CA008748"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neutropenia is commonly encountered in cancer patients. Recombinant human granulocyte colony-stimulating factor (G-CSF, filgrastim), a cytokine that initiates proliferation and differentiation of mature granulocytes, is widely given to oncology patients to counteract neutropenia, reducing susceptibility to infection. However, the clinical impact of neutropenia and G-CSF use in cancer patients with coronavirus disease 2019 (COVID-19) remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An observational cohort of 379 actively treated cancer patients with COVID-19 was assembled to investigate links between concurrent neutropenia and G-CSF administration on COVID-19-associated respiratory failure and death. These factors were encoded as time-dependent predictors in an extended Cox model, controlling for age and underlying cancer diagnosis. To determine whether the degree of granulocyte response to G-CSF affected outcomes, the degree of response to G-CSF, based on rise in absolute neutrophil count (ANC) 24 hours after growth factor administration, was also incorporated into a similar Cox model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the setting of active COVID-19 infection, outpatient receipt of G-CSF led to an increased number of hospitalizations (hazard ratio [HR]: 3.54, 95% confidence interval [CI]: 1.25\u201310.0, P value: .017). Furthermore, among inpatients, G-CSF administration was associated with increased need for high levels of oxygen supplementation and death (HR: 3.56, 95% CI: 1.19\u201310.2, P value: .024). This effect was predominantly seen in patients that exhibited a high response to G-CSF based on their ANC increase post-G-CSF administration (HR: 7.78, 95% CI: 2.05\u201327.9, P value: .004).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The potential risks versus benefits of G-CSF administration should be considered in neutropenic cancer patients with COVID-19, because G-CSF administration may lead to worsening clinical and respiratory status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/cid\/ciab534","type":"journal-article","created":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T15:45:14Z","timestamp":1623167114000},"page":"567-574","source":"Crossref","is-referenced-by-count":25,"title":["The Effect of Neutropenia and Filgrastim (G-CSF) on Cancer Patients With Coronavirus Disease 2019 (COVID-19) Infection"],"prefix":"10.1093","volume":"74","author":[{"given":"Allen W","family":"Zhang","sequence":"first","affiliation":[{"name":"MD\/PhD Program, Faculty of Medicine, University of British Columbia , Vancouver, BC ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sejal","family":"Morjaria","sequence":"additional","affiliation":[{"name":"Infectious Disease, Department of Medicine, Memorial Sloan Kettering Cancer Center , New York, New York ,","place":["USA"]},{"name":"Department of Medicine, Weill Cornell Medical College , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Kaltsas","sequence":"additional","affiliation":[{"name":"Infectious Disease, Department of Medicine, Memorial Sloan Kettering Cancer Center , New York, New York ,","place":["USA"]},{"name":"Department of Medicine, Weill Cornell Medical College , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias M","family":"Hohl","sequence":"additional","affiliation":[{"name":"Infectious Disease, Department of Medicine, Memorial Sloan Kettering Cancer Center , New York, New York ,","place":["USA"]},{"name":"Department of Medicine, Weill Cornell Medical College , New York, New York ,","place":["USA"]},{"name":"Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rekha","family":"Parameswaran","sequence":"additional","affiliation":[{"name":"Hematology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhruvkumar","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Quality and Safety, Memorial Sloan Kettering Cancer Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Zhou","sequence":"additional","affiliation":[{"name":"Operation Excellence, Memorial Sloan Kettering Cancer Center , New York, New York ,","place":["USA"]},{"name":"Advanced Practice Provider Department, Memorial Sloan Kettering Cancer Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Predmore","sequence":"additional","affiliation":[{"name":"MD\/PhD Program, Faculty of Medicine, University of British Columbia , Vancouver, BC ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocio","family":"Perez-Johnston","sequence":"additional","affiliation":[{"name":"Hematology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center , New York, New York ,","place":["USA"]},{"name":"Department of Radiology, Memorial Sloan Kettering Cancer Center , New 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