The Effect of Granulocyte-Macrophage Colony-Stimulating Factor on Neutropenia and Mortality in Neonatal Sepsis

Objective: To evaluate the impact of adjuvant Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF) therapy in neonatal sepsis. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Lahore Pakistan, Mar 2019 to Mar 2020. Methodology: Thirty neonates (15 cases and 15 controls) were randomly selected for this study. The Interventional Group was given GM-CSF and standard-of-care treatment; the Control Group only received standard care. Both groups were followed for the primary outcome (i.e., discharge or death). Secondary outcomes included the effects of GM-CSF on haematological parameters of neonatal sepsis. Results: The mean gestational age of the children was 33.46±2.47 weeks. In the Interventional-Group, 56.7% of the neonates were discharged with the resolution of the sepsis. There was no significant difference concerning the secondary outcome, but the mortality was higher in the neonates among the Control-Group (p-value>0.05). Conclusion: Our study showed no difference in mortality between the Interventional and the Control Groups. The GM-CSF therapy could be used as an adjuvant therapy in neonates with neonatal sepsis to increase the total leukocyte and absolute neutrophil counts. Further studies are needed to holistically chart the clinical benefit of GM-CSF adjuvant therapy.