Granulocyte‐colony stimulating factor in <scp>COVID</scp>‐19: Is it stimulating more than just the bone marrow?

Nawar, Tamara; Morjaria, Sejal; Kaltsas, Anna; Patel, Dhruvkumar; Pérez-Johnston, Rocío; Daniyan, Anthony F.; Mailankody, Sham; Parameswaran, Rekha

doi:10.1002/ajh.25870

Cited by 55 publications

(65 citation statements)

References 6 publications

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“…This was shown in a case series of three cancer patients on active systemic therapy and infected with SARS-CoV-2 (including one BC patient on chemotherapy). All patients developed rising neutrophil/lymphocyte ratio and suffered respiratory decline at 72 h after G-CSF administration [ 94 ];…”

Section: Resultsmentioning

confidence: 99%

Implementation of Breast Cancer Continuum of Care in Low- and Middle-Income Countries During the COVID-19 Pandemic

et al. 2020

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Breast cancer is the most common malignancy among women worldwide. The current COVID-19 pandemic represents an unprecedented challenge leading to care disruption, which is more severe in low- and middle-income countries (LMIC) due to existing economic obstacles. This review presents the global perspective and preparedness plans for breast cancer continuum of care amid the COVID-19 outbreak and discusses challenges faced by LMIC in implementing these strategies. Prioritization and triage of breast cancer patients in a multidisciplinary team setting are of paramount importance. Deescalation of systemic and radiation therapy can be utilized safely in selected clinical scenarios. The presence of a framework and resource-adapted recommendations exploiting available evidence-based data with judicious personalized use of current resources is essential for breast cancer care in LMIC during the COVID-19 pandemic.

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Section: Resultsmentioning

confidence: 99%

Implementation of Breast Cancer Continuum of Care in Low- and Middle-Income Countries During the COVID-19 Pandemic

et al. 2020

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“…However, it is notable that neutropenic patients who have received exogenous G-CSF show increased mortality, providing further support for a potential causal relationship between neutrophil development and activation and adverse clinical outcomes. 41,42 Our study suggests several potential therapeutic strategies, including inhibition of G-CSF, IL-8, or other drivers of neutrophil activation, but the potential benefit of such strategies will need to be weighed carefully against the risks of modulating a key aspect of the innate immune system. The recent finding that dexamethasone improves mortality in COVID-19 offers strong support for the model that immunopathology plays an important role in COVID-19 pathogenesis, 43 but it does not identify the key immune components involved in this process.…”

Section: Discussionmentioning

confidence: 99%

A neutrophil activation signature predicts critical illness and mortality in COVID-19

Meizlish

Pine

Bishai

et al. 2020

Preprint

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Pathologic immune hyperactivation is emerging as a key feature of critical illness in COVID-19, but the mechanisms involved remain poorly understood. We carried out proteomic profiling of plasma from cross-sectional and longitudinal cohorts of hospitalized patients with COVID-19 and analyzed clinical data from our health system database of over 3,300 patients. Using a machine learning algorithm, we identified a prominent signature of neutrophil activation, including resistin, lipocalin-2, HGF, IL-8, and G-CSF, as the strongest predictors of critical illness. Neutrophil activation was present on the first day of hospitalization in patients who would only later require transfer to the intensive care unit, thus preceding the onset of critical illness and predicting increased mortality. In the health system database, early elevations in developing and mature neutrophil counts also predicted higher mortality rates. Altogether, we define an essential role for neutrophil activation in the pathogenesis of severe COVID-19 and identify molecular neutrophil markers that distinguish patients at risk of future clinical decompensation.

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“…However, G-CSF has also been associated with a risk of hyperinflammation during neutrophil regeneration and cases of severe COVID-19 have been reported after G-CSF administration. 44 We therefore do not recommend additional G-CSF prophylaxis on top of current recommendations (DIII). 78 …”

Section: Preventionmentioning

confidence: 98%

“…Of note, patients with lymphopenia 11 , 41 , 42 , 43 and granulocytosis 33 , 44 were reported to be at an increased risk for severe or fatal COVID-19. Further factors with possible impact on COVID-19 course and outcome are listed in Table 2 .…”

Section: Risk Factorsmentioning

confidence: 99%

Evidence-based management of COVID-19 in cancer patients: Guideline by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO)

Giesen

Sprute²,

Rüthrich

et al. 2020

European Journal of Cancer

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Since its first detection in China in late 2019 the novel coronavirus SARS-CoV-2 and the associated infectious disease COVID-19 continue to have a major impact on global health care and clinical practice. Cancer patients, in particular those with haematological malignancies, seem to be at an increased risk for a severe course of infection. Deliberations to avoid or defer potentially immunosuppressive therapies in these patients need to be balanced against the overarching goal of providing optimal antineoplastic treatment. This poses a unique challenge to treating physicians. This guideline provides evidence-based recommendations regarding prevention, diagnostics and treatment of SARS-CoV-2 infection and COVID-19 as well as strategies towards safe antineoplastic care during the COVID-19 pandemic. It was prepared by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO) by critically reviewing the currently available data on SARS-CoV-2 and COVID-19 in cancer patients applying evidence-based medicine criteria.

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Granulocyte‐colony stimulating factor in COVID‐19: Is it stimulating more than just the bone marrow?

Abstract: more evidence-based management recommendations for these patients. Until more data arise, the recommendations we provide herein can be used based on cliniciansʼ best judgment.

Cited by 55 publications

References 6 publications

Implementation of Breast Cancer Continuum of Care in Low- and Middle-Income Countries During the COVID-19 Pandemic

Implementation of Breast Cancer Continuum of Care in Low- and Middle-Income Countries During the COVID-19 Pandemic

A neutrophil activation signature predicts critical illness and mortality in COVID-19

Evidence-based management of COVID-19 in cancer patients: Guideline by the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO)

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