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. 2021;12(2):1-8.

Impact of G-CSF Therapy on Leukopenia and Acute Rejection Following Kidney Transplantation

J Schneider  1 , M Henningsen  1 , P Pisarski  2 , G Walz  1 , B Jänigen  2
Affiliations

Impact of G-CSF Therapy on Leukopenia and Acute Rejection Following Kidney Transplantation

J Schneider et al. Int J Organ Transplant Med. 2021.

Abstract

Background: Leukopenia is a common problem after kidney transplantation. The therapeutic approach typically includes a reduction of the immunosuppressive therapy, which is associated with an increased risk of rejection and allograft loss. Granulocyte colony-stimulating factor (G-CSF) is used as a therapeutic option to raise the leukocyte blood count; however, the effect on acute rejections is controversial.

Objective: The goal of this study is to examine the incidence of acute rejections following G-CSF therapy.

Methods: We retrospectively evaluated patients with leukopenia following kidney transplantation and GCSF therapy between January 2007 and December 2017 at our center compared to controls with matched minimal leucocyte blood count in a matched pair analysis.

Results: We identified 12 patients, who received G-CSF therapy with a cumulative dose of 10.74 µg/kg body weight over a time frame of 4.3 days. G-CSF therapy resulted in a significantly shorter time period with leucocytes <3,000/µL (9.5 vs. 16.6 days), but also trended towards an increased risk of rejection within the next 30 days with three patients in the G-CSF group and no patient in the control group (p=0.06) developing an acute biopsy-proven rejection. Infection and mortality rate in the subsequent year were not different between groups.

Conclusion: G-CSF therapy decreases the duration of leukopenia post-kidney transplantation, but may also increase the risk of an acute rejection.

Keywords: Granulocyte colony-stimulating factor; Kidney transplantation; Leukopenia; Rejection.

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Conflict of interest statement

None to be declare.

Figures

Figure 1
Figure 1
Flowchart of patient recruitment
Figure 2
Figure 2
Histological G-CSF therapy decreases the duration of leukopenia and trends to increase the risk of acute rejection independent of the total dose administered. impact of G-CSF therapy on (A) the duration of leukopenia with a leukocyte count <3,000/µL, (B) on the incidence of acute rejections within the following 30 days, and (C) impact of the cumulative G-CSF dose on the risk of rejection
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