Granulocyte Transfusions for Children with Infection and Neutropenia or Granulocyte Dysfunction

Díaz, Rosa; Soundar, Esther; Hartman, Sarah K.; Dreyer, ZoAnn E.; Teruya, Jun; Hui, Shiu‐Ki Rocky

doi:10.3109/08880018.2013.868562

Cited by 29 publications

(26 citation statements)

References 12 publications

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“…The correlation coefficient which was reported by Seidel was similar to our study (r = 0.316, p = 0.040) [6]. However Diaz et al did find no correlation between administered granulocyte dose and ANC increment [5].…”

Section: Discussionsupporting

confidence: 86%

“…In our study, complete and partial responses were achieved up to 89.5% of neutropenic fever attacks. There were limited studies with different success rates ranging from 60% to 92% [5,[7][8][9][10][11]. Infection related mortality rate was 10.5% in our study.…”

Section: Discussioncontrasting

confidence: 46%

“…Infection related mortality rate was 10.5% in our study. In the pediatric age groups, the mortality rates were reported ranging from 7.4% to 30.8% [3,5,7,8,12]. It should be kept in mind that both of responses to therapy and mortality rates could be affected from the primary disease, the response of primary disease, patient's individual factors, the availability of pediatric intensive care units, the causative microorganisms.…”

Section: Discussionmentioning

confidence: 95%

“…In our study 17 of 56 granulocyte products were splitted which were transfused in maximum 12 hours as suggested by Diaz [5]. Given granulocyte dose per transfusion (9.9 (3.9-52.2)/kg × 10 8 ) with splitted product was not different from main product.…”

Section: Discussionmentioning

confidence: 99%

“…The patients were categorized according to their clinical response as complete if the patient had resolution of fever and physical examination findings within the 48-hour period, partial if the patient's clinical status did not meet criteria for complete response but there was improvement in patient's clinical status and progression if the patient had worsening clinical status or died [5]. Infection related death rate was calculated.…”

Section: Evaluation Of Responsesmentioning

confidence: 99%

See 4 more Smart Citations

Granulocyte transfusion experience in pediatric neutropenic fever: Splitted product can be an alternative?

Oymak¹,

Ayhan

Karapınar³

et al. 2015

Transfusion and Apheresis Science

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Section: Discussionsupporting

confidence: 86%

Section: Discussioncontrasting

confidence: 46%

Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Evaluation Of Responsesmentioning

confidence: 99%

See 3 more Smart Citations

Granulocyte transfusion experience in pediatric neutropenic fever: Splitted product can be an alternative?

Oymak¹,

Ayhan

Karapınar³

et al. 2015

Transfusion and Apheresis Science

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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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Neutropenia

Dale

2015

Encyclopedia of Life Sciences

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Neutropenia is a decrease in the number of neutrophilic leucocytes in the blood. Neutropenia is defined as an absolute neutrophil count or ANC (total white blood cells per litre multiplied by the percentage of neutrophils) more than two standard deviations below the normal mean. The ANC is usually more than 2.0 × 10 9 L −1 . Neutropenia is graded as mild, moderate or severe; severe is less than 0.5 × 10 9 L −1 . Severe neutropenia predisposes to a high risk of bacterial and fungal infections. Neutropenia occurs both as an acquired and as an inherited disorder. Drugs and autoimmune diseases are the common causes of acquired neutropenia. There are many hereditary causes of neutropenia; all of these are rare conditions, but some are quite severe. Proper treatment depends on understanding the cause of neutropenia and its expected duration. Short periods of neutropenia can be managed with careful observation or antibiotics. Patients with severe chronic neutropenia benefit from long‐term treatment with granulocyte colony‐stimulating factor (G‐CSF). Key Concepts Neutrophils are critical for normal defence from infections by bacteria on body surfaces. Blood neutrophil levels below normal, that is, neutropenia, predispose to bacterial and fungal infections. The bone marrow produces neutrophils from haematopoietic stem cells through an orderly process that takes about 10–14 days. Neutropenia is usually due to acquired or intrinsic/hereditary disorders affecting bone marrow production of these cells. When neutrophil production is interrupted by drugs or diseases recovery often takes several days. The risk of infection in patients with neutropenia depends on the severity of neutropenia and its duration. With a brief period, that is, 1–3 days, the risk is relatively low. Severe neutropenia lasting longer is associated with a steadily increasing risk of severe infection and even death. Proper management of neutropenia requires understanding its cause and the expected duration of neutropenia. When it is due to drugs, either cancer chemotherapy or as an idiosyncratic reaction to other drugs, the duration is usually relatively brief and can be managed with observation or antibiotics. Neutropenia lasting more than about 5–7 days and more chronic neutropenia predispose patients to a much higher risk of bacterial and fungal infections. These patients benefit from treatment with granulocyte colony‐stimulating factor (G‐CSF). It is now possible to identify the genetic cause for severe chronic neutropenia in many patients through deoxyribonucleic acid (DNA) sequencing studies. Understanding of the molecular and cellular basis for these disorders is growing rapidly.

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Granulocyte Transfusions for Children with Infection and Neutropenia or Granulocyte Dysfunction

Cited by 29 publications

References 12 publications

Granulocyte transfusion experience in pediatric neutropenic fever: Splitted product can be an alternative?

Granulocyte transfusion experience in pediatric neutropenic fever: Splitted product can be an alternative?

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

Neutropenia

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