Abstract
Background: Granulocyte transfusions (GTs) may increase the absolute neutrophil count (ANC) before hematopoietic regeneration in neutropenic patients after chemotherapy or hematopoietic stem cell transplantation and Support anti-infective immunity. Procedure: We assessed efficacy and tolerability of 778 GTs in 70 treatment episodes of 49 children and 10 Young adults [median age 6.28 y (range: 0.13 to 17.7 y) and 21 y (18.0 to 28.0), respectively] suffering from bacterial (n = 55) and/or fungal (n = 31) infections during neutropenia owing to conventional chemotherapy (n = 14), hematopoietic stein cell transplantation conditioning (it 44), or the underlying disease (n = 1).
We analyzed the impact of body weight. organ dysfunction, neutrophil close on ANC increment. infection elimination, and survival. Results: The median day-5 ANC increment was 1460/mu L, correlating to the administered close.
However, 28-day survival did not correlate to the neutrophil dose nor to the ANC increment., potentially owing to the high number of neutrophils transfused to all patients (median > 6 x 10(9)/kg within 5d). The 28-day survival probability of the total patient cohort was 0.72 +/- 0.06 and the 100-day survival was 0.52 +/- 0.07.
Adverse reactions were rare including fever (<= World Health Organization grade 111. 14%), chills (3%), and mild pulmonary complications (1%). Conclusions: These data corroborate the empirical evidence that GT with sufficient cell doses and rapid availability are a feasible, well-tolerated supplemental means to fight severe infections in neutropenic patients.