Scientific Poster Session III - Original Research

Original Research
  Monday, October 14, 2024
  01:00 PM–02:30 PM

Abstract

Introduction: Neutropenia is seen in kidney transplant recipients (KTRs). Apart from reduction in immunosuppression to combat neutropenia, granulocyte colony stimulating factors (GCSF) are used. Conflicting outcomes are reported on GCSF use with alemtuzumab (ALZ) compared to anti-thymocyte globulin (ATG), and there is a gap in literature on its impact of healthcare resources.

Research Question or Hypothesis: KTRs receiving ALZ induction will have a higher use of GCSF and its associated healthcare resources.

Study Design: A single-center, retrospective cohort study was conducted in adult KTRs who underwent kidney transplantation from October 31, 2019 to October 31, 2021.

Methods: Adult KTRs were compared between ALZ and ATG induction with both groups having a rapid steroid withdrawal regimen. The primary outcome was the difference in GCSF use within 6 months post-transplant. Secondary outcomes included difference in associated healthcare resources (number of clinic visits where GCSF was given or for GCSF alone, related telephone calls), number of rounds of GCSF, change in absolute neutrophil count (ANC) after first GCSF injection, time from transplant to first GCSF use, mycophenolate mofetil (MMF) doses and ANC at 3 and 6 months, and the incidence of rejection and development of donor specific antibodies within 12 months.

Results: A total of 31 of the 146 (21.2%) KTRs receiving ALZ received GCSF compared to 6 of the 79 (7.6%) KTRs receiving ATG (p=0.008). Demographics were similar between the two groups. There was a higher use of associated healthcare resources with ALZ compared to ATG with 45 vs 5 clinic visits, 73% vs 40% of clinic visits for GCSF use alone (p=0.152), and 44 vs 5 telephone calls. There was no difference in the other secondary outcomes except for MMF at 3 months (782 mg/day vs 1416 mg/day, p=0.007).

Conclusion: The use of GCSF was significantly higher with ALZ induction, which required higher use of associated healthcare resources.

Presenting Author

Kristen Szempruch PharmD, BCPS, BCTXP
University of North Carolina Medical Center

Authors

Mary Chandran PharmD, BCTXP, BCPS, CPP, FAST, FCCP
UNC Medical Center

Laura Chargualaf PharmD, BCPS
UNC Health

Jason Ifeanyi PharmD
University of North Carolina Medical Center