Therapeutic granulocyte transfusions for the treatment of febrile neutropenia in patients with hematologic diseases: a 10-year experience at a single institute

Kim, Ki Hwan; Lim, Heon Kil; Kim, Byung-Su; Bang, Soo‐Mee; Kim, Inho; Han, Kyu Sup; Kim, Byoung-Kook; Lee, Sang‐Min; Yoon, Sung‐Soo

doi:10.3109/14653249.2010.529889

Cited by 22 publications

(27 citation statements)

References 36 publications

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“…While hospitals have policies to manage such transfusions, blood centers have not routinely performed anti-A and anti-B titers to identify high-risk group O donors. In Europe, blood centers are testing products and restricting use to group O recipients (reviewed in [154]). The use of platelet additive solutions on a large scale could also lower the risk of hemolysis because such products contain less plasma.…”

Section: Resultsmentioning

confidence: 99%

“…Alloimmunization to granulocyte-specific antigens appears to inhibit the function of transfused granulocytes [160]. Three clinical centers have recently published retrospective analyses of their experience with granulocyte transfusions using optimal mobilization techniques and reported improved survival [154, 162, 163]. An NHLBI-sponsored phase III clinical trial examining the effectiveness of granulocyte transfusions in individuals with neutropenia and infection following dose-intensive chemotherapy or hematopoietic stem cell transplantation is underway [164].…”

Section: Resultsmentioning

confidence: 99%

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Alternative Blood Products and Clinical Needs in Transfusion Medicine

Whitsett

Vaglio

Grazzini

2012

Stem Cells International

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The primary focus of national blood programs is the provision of a safe and adequate blood supply. This goal is dependent on regular voluntary donations and a regulatory infrastructure that establishes and enforces standards for blood safety. Progress in ex vivo expansion of blood cells from cell sources including peripheral blood, cord blood, induced pluripotent stem cells, and human embryonic stem cell lines will likely make alternative transfusion products available for clinical use in the near future. Initially, alloimmunized patients and individuals with rare blood types are most likely to benefit from alternative products. However, in developed nations voluntary blood donations are projected to be inadequate in the future as blood usage by individuals 60 years and older increases. In developing nations economic and political challenges may impede progress in attaining self-sufficiency. Under these circumstances, ex vivo generated red cells may be needed to supplement the general blood supply.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Alternative Blood Products and Clinical Needs in Transfusion Medicine

Whitsett

Vaglio

Grazzini

2012

Stem Cells International

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“…The experience of GTXs for febrile neutropenia at the Seoul National University Hospital between 1999 and 2009 was published in 2011 [42]. Here the authors decided to analyze only 138 episodes of febrile neutropenia in 128 patients who received at least three GTXs per episode.…”

Section: Gtx For Treatment Of Infection: Review Of Recent Studies (Pomentioning

confidence: 99%

Granulocyte transfusions: A concise review for practitioners

Gea-Banacloche

2017

Cytotherapy

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Granulocyte transfusions (GTXs) have been used to treat and prevent infections in neutropenic patients for more than 40 years, despite persistent controversy regarding their efficacy. This narrative review attempts to complement recent systematic reviews by the Cochrane Collaboration and provide both historical context and critical assessment of the most significant clinical studies published over the years. The data suggest that properly collected and promptly infused granulocytes are active against infections, both bacterial and fungal. The most important question that remains unanswered is in which patients the administration of granulocytes will be beneficial. The preponderance of evidence suggests that granulocyte transfusions may be efficacious in few select cases as a temporizing measure to control an infection that is expected (or proven) to be refractory to optimal antimicrobial treatment, and that could otherwise be controlled by marrow recovery, which is expected to happen. In this regard, they are best considered a “bridge” that grants enough time for the recipient to develop their own response to the infection. The challenges to use GTXs successfully are both clinical, in terms of timely identifying the patients who may benefit, and logistical, in terms of optimal selection of donors and collection technique.

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“…In contrast, up to 70% of cases resolve when neutrophils promptly return to normal . Granulocyte transfusions (GTs) have been used as an adjunct to antimicrobial agents with varying success for patients with persistent neutropenia and life‐threatening infections . Initial experience with GTs in the treatment of invasive mold infections was tempered by the occurrence of adverse pulmonary reactions to transfusion, unimpressive neutrophil increments, and the availability of newer, more potent antifungal agents .…”

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confidence: 99%

Role of granulocyte transfusions in invasive fusariosis: systematic review and single‐center experience

et al. 2015

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Background Invasive Fusarium infection is relatively refractory to available antifungal agents (AFAs). Invasive fusariosis (IF) occurs almost exclusively in the setting of profound neutropenia and/or systemic corticosteroid use. Treatment guidelines for IF are not well established, including the role of granulocyte transfusions (GTs) to counter neutropenia. Study Design and Methods We conducted a systematic review, identifying IF cases where GTs were used as adjunctive therapy to AFAs and also report a single-center case-series detailing our experience (1996-2012) of all IF cases treated with AFAs and GTs. In the systematic review cases, GTs were predominantly collected from non-stimulated donors, whereas, in the case-series, they were universally derived from dexamethasone/G-CSF-stimulated donors. Results Twenty-three patients met inclusion criteria for the systematic review and 11 for the case-series. Response rates post-GTs were 30% and 91% in the review and case-series, respectively. Survival to hospital discharge remained low at 30% and 45%, respectively. Ten patients in the systematic review and 3 in the case-series failed to achieve hematopoietic recovery and none of these survived. In the case-series, donor-stimulated GTs generated mean ‘same-day’ neutrophil increments of 3.35 ±1.24 ×109/L and mean overall posttransfusion neutrophil increments of 2.46 ± 0.85 ×109/L. Progressive decrements in neutrophil response to GTs in 2 cases were attributed to GT-related HLA alloimmunization. Conclusion In patients with IF, donor-stimulated GTs may contribute to high response rates by effectively bridging periods of neutropenia/marrow suppression. However, their utility in the absence of neutrophil recovery remains questionable.

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Therapeutic granulocyte transfusions for the treatment of febrile neutropenia in patients with hematologic diseases: a 10-year experience at a single institute

Cited by 22 publications

References 36 publications

Alternative Blood Products and Clinical Needs in Transfusion Medicine

Alternative Blood Products and Clinical Needs in Transfusion Medicine

Granulocyte transfusions: A concise review for practitioners

Role of granulocyte transfusions in invasive fusariosis: systematic review and single‐center experience

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