Incidence of acute cellular rejection following granulocyte colony‐stimulating factor administration in lung transplantation: A retrospective case‐cohort analysis

Granulocyte colony‐stimulating factor ( GCSF ) is an option to treat leukopenia in lung transplant recipients. Conflicting evidence exists regarding its effects on acute cellular rejection ( ACR ). A retrospective, case‐cohort study was conducted to assess whether the use of GCSF in lung transplant recipients is associated with an increased incidence of ACR . Patients had to have received at least one dose of GCSF but were excluded if they received GCSF within 30 days prior to transplant or received a lymphocyte‐depleting agent within 14 days of GCSF administration. Thirty‐five patients who received GCSF within 3 months of transplant met inclusion criteria and 105 patients were identified as controls based on a 1:3 allocation scheme. Incidence of ACR was 57.1% in the GCSF group versus 50.5% in the control group (relative risk ( RR )=1.13; 95% CI , 0.80 to 1.59; P =.48). At 3 months post‐transplant, 74.3% of the GCSF group had a dose reduction or discontinuation of their antiproliferative agent versus 17.1% of the control group ( RR =4.33; 95% CI , 2.73 to 6.89; P <.0001). Rejection severity and incidence of infections was similar among groups. These findings show that GCSF administration within 3 months following lung transplantation was not associated with a higher incidence or severity of ACR .