{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T13:23:42Z","timestamp":1791120222344,"version":"4.1.0"},"reference-count":45,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2001,1,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives.<\/jats:title>\n                  <jats:p>To determine whether adjunctive therapy with recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) could reverse sepsis-associated neonatal neutropenia and improve neonatal survival and to assess its safety compared with conventional therapy in a control group.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study Design.<\/jats:title>\n                  <jats:p>This prospective, randomized, controlled trial was performed in 60 infants with neutropenia and clinical signs of sepsis. A subcutaneous injection of rhGM-CSF (5 \u03bcg\/kg\/day) was administered to 30 of the patients for 7 consecutive days. Hematologic parameters (absolute neutrophil, eosinophil, monocyte, lymphocyte counts, and platelet number) and outcome were compared with 30 conventionally treated (control) patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results.<\/jats:title>\n                  <jats:p>Twenty-five patients from the GM-CSF-treated group and 24 from the conventionally treated group had early-onset sepsis (\u22643 days' postnatal age), and the other 11 patients had late-onset sepsis (&amp;gt;3 days' postnatal age). There was no difference between groups in terms of birth weight; gestational age; gender; maturity; maternal age; and incidence of prolonged rupture of membranes, maternal hypertension, or severity of sepsis. All neonates tolerated GM-CSF well with no adverse reactions. The absolute neutrophil count on day 7 was significantly increased in the GM-CSF-treated group compared with the conventionally treated group: 8088 \u00b1 2822\/mm3 versus 2757 \u00b1 823\/mm3. The mean platelet count was significantly higher on days 14 in the GM-CSF-treated group compared with conventionally treated group: 266\u2009867 \u00b1 55\u2009102\/mm3versus 229\u2009200 \u00b1 52\u2009317\/mm3. Hematologic parameters were otherwise similar between groups before treatment and on day 28. Twenty-seven neonates in the rh-GMCSF group and 21 in the control group survived to hospital discharge. The mortality rate in the rhGM-CSF group (10%) was significantly lower than in the conventionally treated group (30%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion.<\/jats:title>\n                  <jats:p>Treatment with rhGM-CSF is associated with an increase in absolute neutrophil, eosinophil, monocyte, lymphocyte, and platelet counts and decreased mortality in critically ill septic neutropenic neonates. These results suggest that rhGM-CSF may be effective in the treatment of neonatal sepsis with neutropenia, and further randomized trials are needed to confirm its beneficial effects.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.107.1.36","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T23:55:51Z","timestamp":1092441351000},"page":"36-41","source":"Crossref","is-referenced-by-count":105,"title":["A Randomized Trial of Granulocyte-Macrophage Colony-Stimulating Factor in Neonates With Sepsis and Neutropenia"],"prefix":"10.1542","volume":"107","author":[{"given":"Kemal Bi\u02d9lgi\u02d9n,","family":"MD","sequence":"first","affiliation":[{"name":"1 From the Department of Pediatrics, Dicle Medical School, Diyarbak\u0131r, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Yaramis\u0327","sequence":"additional","affiliation":[{"name":"1 From the Department of Pediatrics, Dicle Medical School, Diyarbak\u0131r, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenan","family":"Haspolat","sequence":"additional","affiliation":[{"name":"1 From the Department of Pediatrics, Dicle Medical School, Diyarbak\u0131r, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Ali","family":"Tas\u0327","sequence":"additional","affiliation":[{"name":"1 From the Department of Pediatrics, Dicle Medical School, Diyarbak\u0131r, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sacit","family":"Gu\u0308nbey","sequence":"additional","affiliation":[{"name":"1 From the Department of Pediatrics, Dicle Medical School, Diyarbak\u0131r, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orhan","family":"Derman","sequence":"additional","affiliation":[{"name":"1 From the Department of Pediatrics, Dicle Medical School, Diyarbak\u0131r, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2001,1,1]]},"reference":[{"key":"2021121010004194400_B1","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/S0022-3476(96)70192-0","article-title":"Early-onset sepsis in very low birth weight neonates: a report from the National Institute of Child Health and Human 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