Filtration versus gravity leukapheresis in febrile granulocytopenic patients: a randomized prospective trial

Ambinder, Edward P.; Button, Gail R.; Cheung, Tony; Goldberg, Judith D.; Holland, James F.

doi:10.1182/blood.v57.5.836.836

Cited by 13 publications

(1 citation statement)

References 22 publications

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“…The granulocytes are later eluted off the wool and concentrated for transfusion. This system produces the highest granulocyte yields per unit of donor time and minimizes unwanted lymphocytes, platelets, and red cells [27]. An apparatus of this type was manufactured by Fcnwal Laboratories.…”

Section: Advent Of Biomechanical Equipmentmentioning

confidence: 99%

The historical development of automated hemapheresis

Millward

Hoeltge

1982

J of Clinical Apheresis

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Many studies in the early twentieth century involved attempts to separate white blood cells from whole blood for further examination and experimentation as well as for the treatment of neutropenic patients. In the 1950s, the need to use blood and its derivatives efficiently produced the first apparatus to separate blood continuously in a closed system. The prototypes of present-day continuous flow blood cell separators were developed in the 1960s.

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Section: Advent Of Biomechanical Equipmentmentioning

confidence: 99%

The historical development of automated hemapheresis

Millward

Hoeltge

1982

J of Clinical Apheresis

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Granulocyte transfusions for treating infections in patients with neutropenia or neutrophil dysfunction

Stanworth

Massey

Hyde

et al. 2005

Cochrane Database of Systematic Reviews

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Granulocyte transfusions for treating infections in people with neutropenia or neutrophil dysfunction

Estcourt

Stanworth

Hopewell

et al. 2016

Cochrane Database of Systematic Reviews

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Background Despite modern antimicrobials and supportive therapy bacterial and fungal infections are still major complications in people with prolonged disease-related or treatment-related neutropenia. Transfusions of granulocytes have a long history of usage in clinical practice to support and treat severe infection in high-risk groups of patients with neutropenia or neutrophil dysfunction. However, there is considerable current variability in therapeutic granulocyte transfusion practice, and uncertainty about the beneficial effect of transfusions given as an adjunct to antibiotics on mortality. This is an update of a Cochrane review first published in 2005. Objectives To determine the effectiveness and safety of granulocyte transfusions compared to no granulocyte transfusions as adjuncts to antimicrobials for treating infections in people with neutropenia or disorders of neutrophil function aimed at reducing mortality and other adverse outcomes related to infection. Search methods We searched for randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2016, Issue 2). MEDLINE (from 1946), Embase (from 1974), CINAHL (from 1937), the Transfusion Evidence Library (from 1980) and ongoing trial databases to 11 February 2016. Selection criteria RCTs comparing people with neutropenia or disorders of neutrophil dysfunction receiving granulocyte transfusions to treat infection with a control group receiving no granulocyte transfusions. Neonates are the subject of another Cochrane review and were excluded from this review. There was no restriction by outcomes examined, language or publication status. Data collection and analysis We used standard methodological procedures expected by the Cochrane Collaboration. Main results We identified 10 trials that met the inclusion criteria with a total of 587 participants. We also identified another ongoing trial. These trials were conducted between 1975 and 2015. None of the studies included people with neutrophil dysfunction. The studies differed in the type of infections they included. Six studies included both children and adults, however data were not reported separately for children and adults. The two newest studies gave granulocyte colony stimulating factor (G-CSF) to donors; both were stopped early due to lack of recruitment. Three studies re-randomised participants and therefore quantitative analysis was unable to be performed. Overall the quality of the evidence was very low to low across different outcomes according to GRADE methodology. This was due to many of the studies being at high risk of bias, and many of the outcomes being imprecise. There may be no difference in all-cause mortality over 30 days between participants receiving therapeutic granulocyte transfusions and those that did not (six studies; 321 participants; RR 0.75, 95% CI 0.54 to 1.04; very low-quality evidence). There were no differences between the granulocyte dose subgroups (< 1 x 1010 per day versus ≥ 1 x 1010 per day) (test ...

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Filtration versus gravity leukapheresis in febrile granulocytopenic patients: a randomized prospective trial

Cited by 13 publications

References 22 publications

The historical development of automated hemapheresis

The historical development of automated hemapheresis

Granulocyte transfusions for treating infections in patients with neutropenia or neutrophil dysfunction

Granulocyte transfusions for treating infections in people with neutropenia or neutrophil dysfunction

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