The Function and Fate of Transfused Leukocytes From Donors With Chronic Myelocytic Leukemia in Leukopenic Recipients

Freireich, E. J.; Levin, Robert H.; Whang, John; Carbone, Paul P.; Bronson, William R.; Morse, Edward E.

doi:10.1111/j.1749-6632.1964.tb40726.x

Cited by 175 publications

(30 citation statements)

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“…The therapeutic response to donor GTX is dependent primarily on the quantity of transfused granulocytes, with the objective of raising recipients' peripheral blood neutrophil counts from 500 to 750 cell/ L. 36,37 A high granulocyte yield is achieved by the following methods: 1) increasing the number of neutrophils in a donor's peripheral blood through pretreatment with systemic corticosteroids and recombinant G-CSF, 38 and 2) improved leukocyte concentration techniques, e.g., the continuous flow centrifuge leukapheresis method initially described by Freireich et al in 1965. 39 Transfusion of compatible leukocytes also is helpful, because antileukocyte immunoglobulins in recipients may compromise the life span of transfused granulocytes markedly and unfavorably in- (27) HSCT: hematopoietic stem cell transplantation; GVHD: graft-versus-host disease; ANC: absolute neutrophil count; rIFN-␥1b: recombinant interferon ␥1b; GTX: donor granulocyte transfusion; AML: acute myelogenous leukemia; fluence granulocyte function. A predictor of poor GTX efficacy is neutropenia that lasts Ͼ4 weeks, especially when GTX were given for primary prophylaxis of systemic bacterial and fungal infections.…”

Section: Discussionmentioning

confidence: 99%

“…The donors' immune systems were primed, and granulocytes subsequently were collected as described previously. 27 Briefly, the donors were given a single dose of dexamethasone (8 mg orally) and granulocyte-colony stimulating factor (G-CSF) (5 ****109 NEEDS TO BE ADDED TO TM-SNEW FONT****g/kg body weight subcutaneously) 24 hours before their granulocytes were collected, centrifuged, and irradiated (25 centigrays). 28 Transfusions (Ϸ5.5 ϫ 10 10 granulocytes per transfusion) were given daily or on alternating days, depending on the availability of blood donors.…”

Section: Donor Priming and Granulocyte Collectionmentioning

confidence: 99%

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Recombinant interferon γ1b immune enhancement in 20 patients with hematologic malignancies and systemic opportunistic infections treated with donor granulocyte transfusions

Safdar

Rodriguez

Lichtiger

et al. 2006

Cancer

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BACKGROUNDThe response to antifungal therapy alone often is suboptimal in patients with cancer who have therapy‐refractory neutropenia, and even donor‐derived granulocyte transfusions (GTX) are not always successful. The authors evaluated the safety and efficacy of immune enhancement using recombinant interferon γ1b (rIFN‐γ1b) in patients with cancer who received GTX for refractory, systemic, opportunistic infections.METHODSTwenty recipients of high‐dose donor GTX (≈5.5 × 1010 neutrophils per transfusion) who had received concurrent rIFN‐γ1b between October 2001 and December 2004 were evaluated retrospectively.RESULTSThe median age (± standard deviation [SD]) was 45 ± 17 years. Ten patients (50%) were men, 17 patients (85%) had leukemia, and 3 patients (15%) had myelodysplastic syndrome. The median ± SD Acute Physiology and Chronic Health Evaluation II score was 15 ± 4 (range, 7‐22). Most patients (n = 18 patients; 90%) had recurrent or refractory cancer. In 6 patients (30%) who received allogeneic hematopoietic stem cell transplantation, GTX plus rIFN‐γ1b was given a median ± SD of 26 ± 100 days (range, 12‐372 days) after transplantation. Seventeen patients (85%) had neutropenia during GTX therapy. Five patients (25%) had possible invasive fungal infection, 3 patients (15%) had probable invasive fungal infection, and 11 patients (55%) had proven invasive fungal infection. One patient (5%) had refractory Pseudomonas aeruginosa sepsis. Eight patients (40%) received corticosteroids during GTX plus rIFN‐γ1b therapy. Patients received a median ± SD of 8 ± 7 GTX doses (range, 4‐28 doses) and 9 ± 7 rIFN‐γ1b doses (range, 1‐28 doses), for a mean ± SD cumulative dose (CD) of 400 ± 2621 μg. Other concomitant cytokines were granulocyte‐colony stimulating factor (12 ± 3 doses; CD, 6720 ± 4721 μg) in 15 patients (75%) and granulocyte‐macrophage–colony stimulating factor (12 ± 9 doses; CD, 4750 ± 4410 μg) in 14 patients (70%). Four patients (20%) developed fever, and 2 patients (10%) developed skin rashes. Reversible liver dysfunction (n = 3 patients; 15%) and tachycardia (n = 1 patients; 5%) were considered rIFN‐γ1b‐associated adverse reactions; whereas, in 1 patient (5%), transient dyspnea was attributed to GTX. Four weeks after therapy started, 9 patients (45%) had complete or partial resolution of infection; and, in another 3 patients (15%), the invasive fungal infection had become stable.CONCLUSIONSThe current results indicated that no serious adverse events were associated with rIFN‐γ1b immune enhancement in patients with systemic opportunistic infections who received donor GTX therapy. Cancer 2006. © 2006 American Cancer Society.

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Section: Discussionmentioning

confidence: 99%

Section: Donor Priming and Granulocyte Collectionmentioning

confidence: 99%

Recombinant interferon γ1b immune enhancement in 20 patients with hematologic malignancies and systemic opportunistic infections treated with donor granulocyte transfusions

Safdar

Rodriguez

Lichtiger

et al. 2006

Cancer

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“…The first reports on the use of granulocytes obtained from patients with chronic myeloid leukemia, who had high numbers of granulocytes due to their disease, were quite promising. 3 Several studies in the 1970s also showed positive results of using granulocytes from healthy donors. 4 However, other groups demonstrated only partial or no beneficial effect of granulocyte transfusions.…”

Section: Granulocyte Transfusionsmentioning

confidence: 99%

Granulocyte transfusion therapy: randomization after all?

Drewniak¹,

Kuijpers²

2009

Haematologica

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“…In the 1960s, granulocytes for trasfusion were obtained from patients with chronic myelogenous leuke-mia. Although fi rst reports were quite promising, due to lack of donors, possible engraftment and risk of pathogens transmission, then healthy donors became favoured (12). In the 1970s, when granulocytes from healthy donors were already employed, the results of the studies became more contradictive, showing positive results, but partial or no benefi cial effect as well.…”

Section: The Thrilling Story Of Granulocyte Transfusions: Enthusiastimentioning

confidence: 99%

Granulocyte transfusions

Rimajova¹,

Sopko²,

Martinka³

et al. 2012

BLL

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Neutrophils play an essencial role in the defense of the body against bacterial and fungal infections. Disorders of their number or function signifi cantly increase the risk of life-threatening infection. In spite of the development of growth factors, new broad spectrum antibiotics and antifungal drugs against nearly all known pathogens, severe neutropenia associated with bacterial or invasive fungal infections remains a major cause of morbidity and mortality in patients undergoing aggressive cancer chemotherapy or hematopoietic stem cell transplantation. Lately, an interest about granulocyte transfusions was renewed, what is a logical approach in the management of patients with prolonged 'reversible' severe neutropenia and severe infection, which is not controlled with appropriate antimicrobial and supportive treatment, including recombinant hematopoietic growth factors. It was a consequence of advances in the fi eld of apheresis science, use of sedimenting agents and expecially advances in mobilization of granulocytes to the peripheral blood. It became now possible to collect large numbers of neutrophils. Therefore, the clinical use of granulocyte trasfusions, as a potential life saving treatment option in patients with severe neutropenia and uncontrolled infection in spite of appropriate antimicrobial therapy should be considered, with regard to possible benefi ts and risks (Ref. 74). Full Text in PDF www.elis.sk.

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The Function and Fate of Transfused Leukocytes From Donors With Chronic Myelocytic Leukemia in Leukopenic Recipients

Cited by 175 publications

References 0 publications

Recombinant interferon γ1b immune enhancement in 20 patients with hematologic malignancies and systemic opportunistic infections treated with donor granulocyte transfusions

Recombinant interferon γ1b immune enhancement in 20 patients with hematologic malignancies and systemic opportunistic infections treated with donor granulocyte transfusions

Granulocyte transfusion therapy: randomization after all?

Granulocyte transfusions

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