Granulocyte transfusions in the G-CSF era. Where do we stand?

Robinson, Stephen; Marks, David I.

doi:10.1038/sj.bmt.1704630

Cited by 27 publications

(21 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our WBC dose calculates as 4 ϫ 10 8 granulocytes/kg, which is close to the dose of Ն3 ϫ 10 8 granulocytes/kg recommended in humans (34,45). Our recipient WBC kinetics after transfusion are similar to those described in humans (3,5,39,42), and survival has not correlated with a measurable increase in neutrophils (34). Daily WBC transfusions do not appear to be necessary for success (40).…”

Section: Discussionsupporting

confidence: 51%

Experimental Evidence That Granulocyte Transfusions Are Efficacious in Treatment of Neutropenic Hosts with Pulmonary Aspergillosis

Martinez

Chen

Tong

et al. 2013

Antimicrob Agents Chemother

View full text Add to dashboard Cite

cAlthough polymorphonuclear leukocytes (PMNs) are powerfully anti-Aspergillus, transfusion therapy remains controversial, with conflicting results, and experimental support has been lacking. We devised a pulmonary infection model in neutropenic BALB/c mice, used an antibacterial regimen to prevent confounding sepsis, and optimized PMN induction, purifications, and dose. Mice were given 150 mg/kg cyclophosphamide every 4 days and a gentamicin-vancomycin-clindamycin-imipenem regimen daily beginning 4 days before intranasal challenge with 5 ؋ 10 5 Aspergillus conidia. This regimen produced leukopenia (ϳ10% of normal white blood cell [WBC] count; <10% PMNs) for 10 days, without bacterial superinfection. PMN donors given 100 g/kg recombinant murine granulocyte colony-stimulating factor (G-CSF) for 10 days yielded 11 ؋ 10 7 to 13.6 ؋ 10 7 WBC/ml (81 to 87% PMNs). Infected mice were given PMN transfusions intravenously. In 2 experiments with up to 70% mortality of neutropenic controls, transfusion of 10 7 PMNs 1 and 4 days after challenge had negligible effects on peripheral WBC counts but improved survival (P ‫؍‬ 0.007, 0.02), decreased lung CFU (P ‫؍‬ 0.03, 0.005), and cleared infection in 28 to 50% of survivors. Transfusion of 5 ؋ 10 6 PMNs showed partial protection. Transfusions given every other day did not improve protection. Our present results provide an experimental basis for enthusiasm for PMN transfusions in the therapy of aspergillosis in humans.

show abstract

Section: Discussionsupporting

confidence: 51%

Experimental Evidence That Granulocyte Transfusions Are Efficacious in Treatment of Neutropenic Hosts with Pulmonary Aspergillosis

Martinez

Chen

Tong

et al. 2013

Antimicrob Agents Chemother

View full text Add to dashboard Cite

show abstract

“…Despite these improvements, granulocyte yields from CML patients were still considerably higher than those from glucocorticoid-stimulated healthy donors. Subsequently, interest in GTX declined because the achievable cell dose was only marginally adequate, and antibiotic and antimycotic therapy of neutropenic patients had substantially improved [5,12,13,14]. The introduction of recombinant human granulocyte colony-stimulating factor (rhG-CSF) in the 1990s enabled increasing neutrophil numbers by three- to fivefold with a single subcutaneous administration [15,16,17,18].…”

Section: Introductionmentioning

confidence: 99%

“…Studies performed in the 1960s showed that granulocytes harvested from donors with chronic myeloid leukemia (CML) had a dose-dependent therapeutic benefit when transfused to neutropenic patients [6]. In the 1970s, granulocyte yields obtained from healthy donors improved on the introduction of continuous flow leukapheresis, use of hydroxyethyl starch (HES) as a sedimenting agent, and stimulation of granulocytes using glucocorticoids [5,6,7,8,9,10,11]. Despite these improvements, granulocyte yields from CML patients were still considerably higher than those from glucocorticoid-stimulated healthy donors.…”

Section: Introductionmentioning

confidence: 99%

“…Granulocyte transfusion (GTX) therapy is a logical approach to restore normal polymorphonuclear neutrophils (PMNs) to sufficient numbers in these patients. GTX to neutropenic patients has been studied since the 1930s [5]. Studies performed in the 1960s showed that granulocytes harvested from donors with chronic myeloid leukemia (CML) had a dose-dependent therapeutic benefit when transfused to neutropenic patients [6].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Efficacy and Side Effects of Granulocyte Collection in Healthy Donors

Brockmann

Kramer

Bornhäuser

et al. 2013

Transfus Med Hemother

View full text Add to dashboard Cite

Background: We report on the efficacy and side effects of granulocyte collection, which is comparatively infrequently performed in Germany. Methods: Data from 378 healthy donors who underwent 914 granulocyte collections between 1999 and 2007 were retrospectively analyzed. Donors received G-CSF (lenograstim) at a median dose of 5.58 (3.25-7.36) µg/kg body weight with (n = 243) or without (n = 57) 4 mg dexamethasone. Side effects were recorded by donor monitoring and interview (questionnaire). Results: The median granulocyte yield in apheresis products was 8.47 × 10¹⁰ (3.07-14.92 × 10¹⁰). Granulocyte yields correlated significantly with gender, baseline WBC, PMN and PLT counts, and nicotine consumption. Dexamethasone and lenograstim administration was more effective than lenograstim administration alone (p < 0.001). Side effects of granulocyte mobilization were generally mild: bone pain in 31.4%, headache in 19.6%, and fatigue in 15.7% of donors. During follow-up (4 weeks), pruritus and/or exanthema were reported in 17.6% of donors. Conclusions: Granulocyte mobilization with lenograstim with or without dexamethasone was a safe and effective regimen for granulocyte mobilization. Side effects were tolerable and milder than those seen in peripheral blood stem cell donors. Long-term monitoring of granulocyte donors is important to establish optimal standards for the procedure.

show abstract

“…[99][100][101] Corticosteroids are usually given as prednisone or dexamethasone. 105,106 A uniform dose of 450 μg of G-CSF coupled with 8 mg of dexamethasone, both given 12 hours before collection, has been shown to be as effective as larger combined doses.…”

Section: Granulocytapheresismentioning

confidence: 99%