Granulocyte transfusions for neonates with confirmed or suspected sepsis and neutropenia

Abstract

Currently, there is inconclusive evidence from randomised controlled trials (RCTs) to support or refute the routine use of granulocyte transfusions in neutropenic, septic neonates. Researchers are encouraged to conduct adequately powered multi-centre trials of granulocyte transfusions in neutropenic septic neonates.

Adjuvant therapy in neonatal sepsis to prevent mortality - A systematic review and network meta-analysis

“…Hence, adjuvant therapies such as granulocyte transfusion and GCSF/GMCSF have been evaluated as adjuncts in the treatment of neonatal sepsis. The recent Cochrane systematic reviews did not find a reduction in all-cause mortality before discharge with either of these adjuvant therapies [7, 8]. In this NMA, though granulocyte transfusion was associated with a reduction in all-cause mortality, the evidence was very uncertain due to very low CoE.…”

Adjuvant therapy in neonatal sepsis to prevent mortality - A systematic review and network meta-analysis

“…Hence, adjuvant therapies such as granulocyte transfusion and GCSF/GMCSF have been evaluated as adjuncts in the treatment of neonatal sepsis. The recent Cochrane systematic reviews did not find a reduction in all-cause mortality before discharge with either of these adjuvant therapies [7, 8]. In this NMA, though granulocyte transfusion was associated with a reduction in all-cause mortality, the evidence was very uncertain due to very low CoE.…”

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

“…Twelve studies were excluded because they evaluated the therapeutic use of granulocyte transfusions (Alavi 1977; Bow 1984; DRKS00000218; Herzig 1977; Higby 1975; Klastersky 2001; Price 2014; Scali 1978; Seidel 2008; Vogler 1977; Wheeler 1987; Winston 1982)Two studies evaluated the prophylactic use of granulocyte transfusions in neonates (Baley 1987; Christensen 1982)Two studies compared two different types of granulocyte transfusions (Ambinder 1981; Freireich 2013)Five studies were not randomised (Altrichter 2011; Atay 2011; Ikemoto 2012; NCT01932710; UMIN000014777)One study included both randomised and allocated people, and the results of the study did not separate out these categories of enrolled participants. (Buckner 1983)One article study was a review (Pammi 2011)…”

Granulocyte transfusions in severe aplastic anemia

“…To date, there has been inconclusive evidence of the efficacy of GT in SAA and other at-risk populations due to several limitations including variable granulocyte collection methods, poor patient accrual in randomized controlled trials, and physician bias with randomizing patients to GT due to pre-conceived beliefs about the efficacy of these transfusions. 1,3,7 A Cochrane review of ten randomized controlled trials with 587 patients evaluating efficacy of GT versus standard antimicrobial therapy alone found insufficient evidence that GT affected all-cause mortality. 8 The majority of the studies included in this review did not use granulocyte colony-stimulating factor (G-CSF) for donor stimulation, whereas this is now commonly given to granulocyte donors, and thus the transfused products had substantially lower granulocyte content.…”

Adjuvant therapy in neonatal sepsis to prevent mortality - A systematic review and network meta-analysis

“…Hence, adjuvant therapies such as granulocyte transfusion and GCSF/GMCSF have been evaluated as adjuncts in the treatment of neonatal sepsis. The recent Cochrane systematic reviews did not find a reduction in all-cause mortality before discharge with either of these adjuvant therapies [7, 8]. In this NMA, though granulocyte transfusion was associated with a reduction in all-cause mortality, the evidence was very uncertain due to very low CoE.…”

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

“…Twelve studies were excluded because they evaluated the therapeutic use of granulocyte transfusions (Alavi 1977; Bow 1984; DRKS00000218; Herzig 1977; Higby 1975; Klastersky 2001; Price 2014; Scali 1978; Seidel 2008; Vogler 1977; Wheeler 1987; Winston 1982)Two studies evaluated the prophylactic use of granulocyte transfusions in neonates (Baley 1987; Christensen 1982)Two studies compared two different types of granulocyte transfusions (Ambinder 1981; Freireich 2013)Five studies were not randomised (Altrichter 2011; Atay 2011; Ikemoto 2012; NCT01932710; UMIN000014777)One study included both randomised and allocated people, and the results of the study did not separate out these categories of enrolled participants. (Buckner 1983)One article study was a review (Pammi 2011)…”

Granulocyte transfusions in severe aplastic anemia

“…To date, there has been inconclusive evidence of the efficacy of GT in SAA and other at-risk populations due to several limitations including variable granulocyte collection methods, poor patient accrual in randomized controlled trials, and physician bias with randomizing patients to GT due to pre-conceived beliefs about the efficacy of these transfusions. 1,3,7 A Cochrane review of ten randomized controlled trials with 587 patients evaluating efficacy of GT versus standard antimicrobial therapy alone found insufficient evidence that GT affected all-cause mortality. 8 The majority of the studies included in this review did not use granulocyte colony-stimulating factor (G-CSF) for donor stimulation, whereas this is now commonly given to granulocyte donors, and thus the transfused products had substantially lower granulocyte content.…”

Adjuvant therapy in neonatal sepsis to prevent mortality - A systematic review and network meta-analysis

“…Hence, adjuvant therapies such as granulocyte transfusion and GCSF/GMCSF have been evaluated as adjuncts in the treatment of neonatal sepsis. The recent Cochrane systematic reviews did not find a reduction in all-cause mortality before discharge with either of these adjuvant therapies [7, 8]. In this NMA, though granulocyte transfusion was associated with a reduction in all-cause mortality, the evidence was very uncertain due to very low CoE.…”

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

“…Twelve studies were excluded because they evaluated the therapeutic use of granulocyte transfusions (Alavi 1977; Bow 1984; DRKS00000218; Herzig 1977; Higby 1975; Klastersky 2001; Price 2014; Scali 1978; Seidel 2008; Vogler 1977; Wheeler 1987; Winston 1982)Two studies evaluated the prophylactic use of granulocyte transfusions in neonates (Baley 1987; Christensen 1982)Two studies compared two different types of granulocyte transfusions (Ambinder 1981; Freireich 2013)Five studies were not randomised (Altrichter 2011; Atay 2011; Ikemoto 2012; NCT01932710; UMIN000014777)One study included both randomised and allocated people, and the results of the study did not separate out these categories of enrolled participants. (Buckner 1983)One article study was a review (Pammi 2011)…”

Granulocyte transfusions in severe aplastic anemia

“…To date, there has been inconclusive evidence of the efficacy of GT in SAA and other at-risk populations due to several limitations including variable granulocyte collection methods, poor patient accrual in randomized controlled trials, and physician bias with randomizing patients to GT due to pre-conceived beliefs about the efficacy of these transfusions. 1,3,7 A Cochrane review of ten randomized controlled trials with 587 patients evaluating efficacy of GT versus standard antimicrobial therapy alone found insufficient evidence that GT affected all-cause mortality. 8 The majority of the studies included in this review did not use granulocyte colony-stimulating factor (G-CSF) for donor stimulation, whereas this is now commonly given to granulocyte donors, and thus the transfused products had substantially lower granulocyte content.…”