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Neutropenia in pediatric solid organ transplant
Lyndsay A Harshman1, Robin Williams2, Rachel M Engen3
1Stead Family Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, USA.
Pediatric Transplantation
|August 20, 2022
Summary
Pediatric neutropenia, a low neutrophil count, affects up to 30% of solid organ transplant recipients. Management focuses on underlying causes, with granulocyte colony-stimulating factor (G-CSF) potentially aiding severe cases.
Area of Science:
- Pediatric Hematology
- Transplant Immunology
- Immunosuppression Management
Background:
- Neutropenia, defined as an absolute neutrophil count <1500/mm³.
- Occurs in 25%-30% of pediatric solid organ transplant (SOT) recipients within the first year.
- Commonly caused by drug-induced bone marrow suppression, viral infections, nutritional deficiencies, or inherited factors.
Purpose of the Study:
- To review the definition, causes, and management of neutropenia in pediatric SOT recipients.
- To discuss the role of granulocyte colony-stimulating factor (G-CSF) in managing neutropenia in this population.
Main Methods:
- Literature review of neutropenia in pediatric SOT recipients.
- Analysis of causes, outcomes, and management strategies.
- Evaluation of G-CSF use based on observational data.
Main Results:
- Neutropenia is a frequent complication in pediatric SOT recipients.
- Outcomes are influenced by the degree of neutropenia and transplant type.
- Addressing underlying causes is the primary management strategy.
Conclusions:
- Management involves identifying and treating the underlying cause of neutropenia.
- Consultation with pediatric hematologists and judicious use of G-CSF may be beneficial.
- Limited data exist on G-CSF outcomes, but observational studies suggest potential benefit in severe cases or infections.
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