Renewed Interest in Granulocyte Transfusion Therapy

Dale, David C.; Liles, W. Conrad; Price, Thomas H.

doi:10.1046/j.1365-2141.1997.3023119.x

Cited by 47 publications

(37 citation statements)

References 44 publications

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“…The use of this therapy declined dramatically for several reasons, including difficulties in storing and processing granulocytes, the development of more potent antimicrobial agents and alternative agents such as recombinant hematopoietic growth factors and IVIG, and the lack of randomized trials demonstrating efficacy. [5][6][7][8][9][10] In the early 1990s, Bensinger et al 11 demonstrated that high yields of granulocytes could be collected safely from normal donors by administering G-CSF, and Strauss 6 suggested that the major factor limiting the clinical efficacy of granulocyte therapy might be the relatively small dose of granulocytes achievable with conventional mobilizing strategies. Subsequently, renewed enthusiasm followed several reports of clinical efficacy in patients receiving larger doses of granulocytes.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Granulocyte transfusion therapy was enthusiastically advocated in the 1970s and early 1980s. [5][6][7][8][9][10] However, the use of granulocyte transfusion therapy has rapidly declined, due in part to toxicity and the introduction of new antimicrobial agents and recombinant hematopoietic growth factors. [5][6][7][8][9][10] Recently, granulocyte transfusion therapy has received renewed interest following several reports of efficacy following transfusion of granulocytes collected from normal donors stimulated with G-CSF.…”

Section: Introductionmentioning

confidence: 99%

“…[5][6][7][8][9][10] However, the use of granulocyte transfusion therapy has rapidly declined, due in part to toxicity and the introduction of new antimicrobial agents and recombinant hematopoietic growth factors. [5][6][7][8][9][10] Recently, granulocyte transfusion therapy has received renewed interest following several reports of efficacy following transfusion of granulocytes collected from normal donors stimulated with G-CSF. [9][10][11][12][13][14] Mobilizing agents used to stimulate granulocytosis in healthy donors include corticosteroids and G-CSF.…”

Section: Introductionmentioning

confidence: 99%

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Clinical efficacy of granulocyte transfusion therapy in patients with neutropenia-related infections

et al. 2001

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Granulocyte transfusions have been advocated by some for the treatment of severe, progressive infections in neutropenic patients who fail to respond to antimicrobial agents and recombinant hematopoietic growth factors. We conducted the current study to determine an appropriate method of granulocyte mobilization in healthy donors, and to evaluate the safety and efficacy of granulocyte transfusion therapy in patients with neutropenia-related infections. To mobilize granulocytes (n = 55), healthy normal donors were stimulated in one of the following ways: (1) dexamethasone, 3 mg/m 2 intravenously 15 min prior to leukapheresis (n = 5); (2) granulocyte colony-stimulating factor (G-CSF), 5 g/kg subcutaneously 12 to 14 h prior to collection (n = 37); or (3) G-CSF and dexamethasone (n = 13). The mean granulocyte yield from stimulation with G-CSF plus dexamethasone was significantly higher than from stimulation with dexamethasone or G-CSF alone. Twenty-five patients with severe neutropenia-related infections unresponsive to appropriate antimicrobial agents received a total of 55 granulocyte transfusions. The patients from whom fungi or Gram-negative organisms were isolated showed a more favorable response than those infected with Gram-positive organisms. However, the responses to the granulocyte transfusion therapy could not be correlated with the transfused dose, mobilization agents, or the 1 h or 24 h post-transfusion absolute neutrophil counts. We conclude that granulocyte transfusion therapy may be clinically useful for neutropenia-related infections by fungi or Gram-negative organisms. Leukemia (2001) 15, 203-207.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical efficacy of granulocyte transfusion therapy in patients with neutropenia-related infections

et al. 2001

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“…In the pre-G-CSF era several centres had investigated the use of prophylactic granulocyte transfusions but with limited success. [68][69][70][71][72] As discussed above, a major limitation of these studies was the inadequate dose of granulocytes administered, and in a meta-analysis of eight such controlled studies there was a suggestion that granulocyte dose and leucocyte compatibility were important determinants of efficacy. 73 Several groups have reported the use of prophylactic G-CSF primed GTX in patients undergoing allogeneic stem cell transplantation, 32,55,56 autologous stem cell transplantation 33 and patients with a prior history of fungal infection who are receiving an allogeneic bone marrow transplant.…”

Section: Prophylactic Granulocyte Transfusionsmentioning

confidence: 99%

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

Robinson

Marks

2004

Bone Marrow Transplant

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“…Finally, in 25 of them (5.3%) such information was not available. Median dose of rhG-CSF administered was 10 g/kg/day (range, [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], with 387 (81.3%) donors receiving 10 g/kg/day. Seventy-two donors received Ͼ10 g/kg/day (median 12 g/kg; range, 10.8-20), and only 17 donors (3.6%) received Ͻ10 g/kg/day (median 5 g/kg; range, 4-9).…”

Section: Rhg-csf Administrationmentioning

confidence: 99%

Administration of recombinant human granulocyte colony-stimulating factor to normal donors: results of the Spanish National Donor Registry

Rubia

Martı́nez²,

Solano³

et al. 1999

Bone Marrow Transplant

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Summary:A Spanish National PBPC Donor Registry has recently been established for short-and long-term safety data collection in normal donors receiving rhG-CSF. To date, 466 donors have been included in the Registry. Median (range) dose and duration of rhG-CSF administration was 10 g/kg/day (4-20) and 5 days (4-8), respectively. Donors underwent a median of two aphereses (range, 1-5). Adverse effects consisted mainly of bone pain (90.2%), headache (16.9%) and fever (6.1%), but no donor discontinued rhG-CSF prematurely due to toxicity. Side-effects were more frequent in donors receiving Ͼ10 g/kg/day than in those with lower doses (82.8% vs 61.8%; P = 0.004). A significant decrease between baseline and post-apheresis platelet counts was the most important analytical finding (229 ؋ 10 9 /l vs 140 ؋ 10 9 /l; P Ͻ 0.0001), with a progressive reduction in platelet count with each apheresis procedure. One donor developed pneumothorax that required hospitalization due to central venous line placement. The mean CD34 ؉ cell dose collected was 6.9 ؋ 10 6 /kg (range, 1.3-36), with only 14 donors (2.9%) not achieving a minimum target of CD34 ؉ cells of 2 ؋ 10 6 /kg. No definitive information about potential long-term side effects is yet available. However, we hope this National Registry will serve as a useful basis for better monitoring of the efficiency and side-effects of cytokine administration in healthy people. Keywords: granulocyte colony-stimulating factor; normal donors; stem cell mobilization; side-effects Recombinant human granulocyte colony-stimulating factor (rhG-CSF) is being widely used to treat neutropenia secondary to chemotherapy and to collect peripheral blood progenitor cells (PBPC) for use in autologous transplantation. [1][2][3] More recently, rhG-CSF has been given to healthy people for granulocyte collection, 4,5 and to mobilize and collect PBPC for allogeneic transplants. [6][7][8][9][10] In the allogeneic setting, the routine use of mobilized PBPC must be based not only on clinical results, but also on the safety of donors. remain important issues. Regarding this, the optimal dose and schedule of rhG-CSF for mobilization of PBPC have not been definitively established, and specific information about short-and long-term biological and clinical effects of rhG-CSF in normal donors is still limited. Thus, a prolonged follow-up of donors is clearly needed in order to rule out the development of toxicity and to ensure that administration of this cytokine to healthy individuals is completely devoid of long-term side-effects. This task will be more easily approached by the development of PBPC national or international donor registries that allow the inclusion of higher number of donors. 11,12 In Spain, a National PBPC Donor Registry has recently been developed to address potential adverse effects of the administration of rhG-CSF to normal donors for PBPC mobilization and collection. The objectives of this registry include a standardized data collection for the different centers administering rhG-CSF to normal d...

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Renewed Interest in Granulocyte Transfusion Therapy

Cited by 47 publications

References 44 publications

Clinical efficacy of granulocyte transfusion therapy in patients with neutropenia-related infections

Clinical efficacy of granulocyte transfusion therapy in patients with neutropenia-related infections

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

Administration of recombinant human granulocyte colony-stimulating factor to normal donors: results of the Spanish National Donor Registry

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