Granulocyte Colony Stimulating Factor in Burn Patients with Neutropenia

Objective: To assess the role of granulocyte-colony stimulating factor (G-CSF) for improving neutropenia in burns patients with neutropenia. Study Design: Experimental study. Place and Duration of Study: Jinnah Burn and Reconstructive Surgery Centre, Lahore, from May to October 2017. Methodology: Patients with burn injury, having absolute neutrophil count (ANC) <500 / mu L or where it was expected to decrease to <500/mu L within the next 48 hours, were recruited in the study. A detailed demographic profile of patients was taken, burn site was evaluated, and sample collection by phlebotomy was done in the complete blood count (CBC) vial. Samples were run in a CBC analyser and verification of neutrophil count on the neubuar chamber was done. ANC was taken for 3 days for each patient. Injection Filgrastim was given 300 mu g subcutaneous (S/C) or intravenous (I/V) once daily until the neutropenia improved. Improvement was categorised as good, moderate and poor, depending on the number of days for improvement in ANC. The response was further stratified on the basis of age, gender and percentage of burn. Results: A total of 39 patients with mean age of 32.1 +/- 14.4 years included 84.6% (n=33) males and 15.4% (n=6) females. Mean percentage of burn was 40.5 +/- 15.7%. In 12-40 years of age, there were 30/39 (76.9%) patients. Among them, 11/30 (36.6%) were good, 13/30 (43.3%) were moderate, and 6/30 (20%) were poor responders. In 41-70 years of age, there were 9/39 (23.1%) patients. Among them, 2/9 (22.2%) were good, 4/9 (44.44%) were moderate, and 3/9 (33.3%) were poor responders (p = 0.616). Conclusion: The addition of G-CSF injections to the standard treatment of burn injury markedly improve the neutrophil counts in burn patients with neutropenia.