Clinical outcomes of febrile neutropenia with colony stimulating factors: A multicenter retrospective analysis.

Abstract

e24141 Background: Patients with solid and hematologic malignancies receiving cytotoxic chemotherapy are vulnerable to febrile neutropenia (FN), a high-risk complication that often necessitates hospitalization and can lead to treatment delays, morbidity, or death. Granulocyte colony-stimulating factor (G-CSF) is often used for prevention of FN, however its benefits in treatment of hospitalized patients with FN are not well understood. Methods: We performed a retrospective cohort analysis using de-identified patient data from the HCA healthcare national database from 2016 to 2022. Adult patients hospitalized with FN and diagnosis of a hematologic or solid malignancy were included. Patients were stratified by inpatient G-CSF use, and propensity matched using the Van Walraven score. Primary outcomes include hospital length of stay and time to neutrophil recovery. Secondary outcomes include inpatient mortality. Results: Among 2,065 patients, 90 (4.4%) received inpatient G-CSF. G-CSF use was associated with a shorter median hospital length of stay (8 versus 12 days, p-value: <0.01 [95% CI:0.66-0.91]) and faster neutrophil recovery (4 versus 5 days, p-value: <0.01 [95% CI: 0.97-0.98]). There was no significant difference in inpatient mortality. Conclusions: The aim of this retrospective study was to evaluate the clinical outcomes of G-CSF administration to hospitalized patients with FN. G-CSF use in hospitalized patients with FN significantly reduced neutrophil count recovery time (4 versus 5 days) and decreased length of hospitalization (8 versus 12 days), suggesting a benefit of G-CSF in select hospitalized populations with FN. Our findings complement previous research study findings by underlining that there is a significant decrease in length of hospitalization when using G-CSF compared to the control group. Such findings can help inform current guidelines regarding the use of G-CSF as secondary prophylaxis in hospitalized patients with febrile neutropenia. Negative binomial regression for days to recovery and hospital length of stay. Days to Recovery 1 IRR 95% Confidence Interval p-value G-CSF 0.98 0.97 0.98 <0.01 Hospital Length of Stay 2 IRR 95% Confidence Interval p-value G-CSF 0.87 0.66 0.91 <0.01 1: The incidence rate ratio (IRR) of patients receiving G-CSF was 0.98 (CI: 0.97-0.98, p-value: <0.01), indicating a statistically significant difference in days to recovery between the group that received G-CSF and the non-G-CSF group. 2: The incidence rate ratio (IRR) of patients receiving G-CSF was 0.78 (CI: 0.66-0.91, p-value of <0.01), indicating a statistically significant difference in length of hospital stay between the groups that received G-CSF and the non-G-CSF group.