Granulocyte transfusions for neutropenic patients with life‐threatening infections: a single centre experience in 47 patients, who received 348 granulocyte transfusions

Ofran, Yishai; Avivi, Irit; Oliven, Anita; Oren, Ilana; Zuckerman, Tsila; Bonstein, Lilach; Rowe, Jacob M.; Dann, Eldad J.

doi:10.1111/j.1423-0410.2007.00971.x

Cited by 39 publications

(50 citation statements)

References 32 publications

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“…17 Recent studies of therapeutic granulocyte transfusions for neutropenic infections in patients with leukemia and/or undergoing HSCT have shown survival rates of 31-81%; in patients with invasive fungal infections, the survival rates range from 20-80%. These studies, summarized in Table 4, [1][2][3][4][5][6][18][19][20][21][22][23][24][25] vary in the definition of invasive fungal infections, the timing of initiating granulocyte therapy, the cell dose of granulocytes transfused, and the number of granulocyte doses given. One study was randomized, but only 60% of patients were actually neutropenic prior to receiving granulocytes, and 44% of patients randomized to the granulocyte arm received only one or two transfusions before neutrophil recovery.…”

Section: Discussionmentioning

confidence: 99%

Granulocyte transfusions in severe aplastic anemia: an eleven-year experience

Quillen¹,

Wong

Scheinberg

et al. 2009

Haematologica

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Section: Discussionmentioning

confidence: 99%

Granulocyte transfusions in severe aplastic anemia: an eleven-year experience

Quillen¹,

Wong

Scheinberg

et al. 2009

Haematologica

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“…Granulocyte transfusions have long been recognized as a potential therapeutic option for treating infections in individuals with neutropenia [6,38,39]. Nonetheless, the use of granulocyte transfusions has remained infrequent and only about 1000 granulocyte units are transfused per year in the US [1].…”

Section: Introductionmentioning

confidence: 99%

Membrane permeability of the human granulocyte to water, dimethyl sulfoxide, glycerol, propylene glycol and ethylene glycol

Vian

Higgins

2014

Cryobiology

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Granulocytes are currently transfused as soon as possible after collection because they rapidly deteriorate after being removed from the body. This short shelf life complicates the logistics of granulocyte collection, banking and safety testing. Cryopreservation has the potential to significantly increase shelf life; however, cryopreservation of granulocytes has proven to be difficult. In this study, we investigate the membrane permeability properties of human granulocytes, with the ultimate goal of using membrane transport modeling to facilitate development of improved cryopreservation methods. We first measured the equilibrium volume of human granulocytes in a range of hypo- and hypertonic solutions and fit the resulting data using a Boyle-van't Hoff model. This yielded an isotonic cell volume of 378 μm3 and an osmotically inactive volume of 165 μm3. To determine the permeability of the granulocyte membrane to water and cryoprotectant (CPA), cells were injected into well-mixed CPA solution while collecting volume measurements using a Coulter Counter. These experiments were performed at temperatures ranging from 4 to 37 °C for exposure to dimethyl sulfoxide, glycerol, ethylene glycol and propylene glycol. The best-fit water permeability was similar in the presence of all of the CPAs, with an average value at 21 °C of 0.18 μm atm−1 min−1. The activation energy for water transport ranged from 41 to 61 kJ/mol. The CPA permeability at 21 °C was 6.4, 1.0, 8.4 and 4.0 μm/min for dimethyl sulfoxide, glycerol, ethylene glycol and propylene glycol, respectively, and the activation energy for CPA transport ranged between 59 and 68 kJ/mol.

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“…Ofran et al [11] showed that a sustained increase in neutrophil count following GTX's ([700 cells/ll) was the only independent prognostic factor for infection-related survival. This observation might reflect a 'favorable' subgroup of patients, whose granulocyte consumption was modest due to a less severe infection that therefore attained a sustained 'high' neutrophil count.…”

Section: Discussionmentioning

confidence: 98%

“…Several recent clinical studies have shown clinical benefits of GTX in HSCT recipients with severe bacterial or fungal infections [7,10,11]. Patients with active invasive fungal infections with a very high risk primary disease without HSCT received antifungal agents combined with GTX and the results were presented retrospectively.…”

Section: A Resistant Severe Clinical Infection In a Neutropenicmentioning

confidence: 99%

Hematopoietic Stem Cell Transplantation in a Very High Risk Group of Patients with the Support of Granulocyte Transfusion

Yenicesu

Sucak

Dilsiz

et al. 2011

Indian J Hematol Blood Transfus

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High risk patients with active fungal infection who had undergone hematopoietic stem cell transplantation (HSCT) with the support of granulocyte transfusions (GTX) as an adjunct to antifungal agents are reviewed retrospectively. Patients requiring immediate allogeneic HSCT for their primary hematological disorders (two severe aplastic anemia, one T cell acute lymphoblastic leukemia (ALL) in second complete remission, one acute myeloid leukemia (AML)-in first complete remission, one T-ALL in refractory relapse) but were denied by other transplant programs due to active invasive fungal infections had undergone HSCT with the support of GTX at the stem cell transplantation unit of Gazi University. Five patients who had undergone six transplants were included in the study and received a total of 38 (3-13) granulocyte transfusions during these six transplants. The median granulocyte concentration was 3.4 × 10(11) per apheresis bag. Full clinical and radiological recovery was achieved in three of the five high risk patients with active invasive fungal infection with the combination of antifungal agents and GTX. Even a very high risk patient with aplastic anemia who had undergone two consecutive transplants due to secondary graft failure was also cured of his primary disease despite the presence of multiple pulmonary fungus balls. Three of the five patients with very high risk features due to the underlying hematological disease and the associated active fungal infection were rescued with allogeneic HSCT performed with the support of GTX combined with antifungal agents. Despite the limitations of this report due to its retrospective nature, it suggests that GTX might be an alternative in patients with active fungal infections who otherwise are denied by the transplant programs. However, prospective randomized studies are required to draw a solid conclusion regarding the role of GTX in HSCT recipients in desperate situations such as active fungal infections.

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Granulocyte transfusions for neutropenic patients with life‐threatening infections: a single centre experience in 47 patients, who received 348 granulocyte transfusions

Abstract: GTs are safe and should be considered for patients with life-threatening neutropenic infections. However, prospective randomized studies of GTs are the only way to establish the true role of GTs.

Cited by 39 publications

References 32 publications

Granulocyte transfusions in severe aplastic anemia: an eleven-year experience

Granulocyte transfusions in severe aplastic anemia: an eleven-year experience

Membrane permeability of the human granulocyte to water, dimethyl sulfoxide, glycerol, propylene glycol and ethylene glycol

Hematopoietic Stem Cell Transplantation in a Very High Risk Group of Patients with the Support of Granulocyte Transfusion

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