Tolerance of granulocyte donors towards granulocyte colony‐stimulating factor stimulation and of patients towards granulocyte transfusions: results of a multicentre study

Abstract

Data of 507 granulocyte donations from 183 donors were evaluated. No severe granulocyte colony-stimulating factor (G-CSF)-related side-effects were observed. Three donors complained of severe itching following infusion of hydroxyethyl starch (HES). A high proportion (85%) of the donors stated that they would donate granulocytes again. The mean granulocyte yield was 4.3 x 10(10). High-molecular-weight HES resulted in a significantly higher yield compared with low-molecular-weight HES. Mild, but no severe, adverse transfusion reactions were observed in 16% of the recipients. A leucocyte alloimmunization rate of 24% was found. G-CSF stimulation and transfusion of G-CSF-mobilized granulocytes were well tolerated by donors and recipients, respectively.

Donor tolerance and results of stimulation with G‐CSF alone or in combination with dexamethasone for the collection of granulocytes

“…The side effects of G-CSF have been extensively studied in stem cell donors but data about adverse events in granulocytes donors are scarce. Although the G-CSF dose is lower and given on a shortterm basis, granulocyte donors experience side effects up to 63% after G-CSF stimulation [9]. As corticoids may influence the number of side effects, the present study was undertaken to compare donor tolerance and results of stimulation of G-CSF alone (historical control) with G-CSF and dexamethasone.…”

3 Granulocyte Concentrates

“…GCs from donors pretreated with G-CSF is tolerated well [6]. Fever, chills, and skin irritations are the most frequently observed reactions.…”

“…This pretreatment with G-CSF significantly increases granulocyte yield [5,7] and prolongs granulocyte survival time [15]. To achieve better separation of granulocytes from erythrocytes, during apheresis the collected blood is supplemented by a sedimenting agent, usually 6% high-molecular-weight hydroxyethyl starch (HES) [6]. Because of the risk of severe itching following infusion of HES, granulocyte donations are limited to four per donor and year [6,10].…”

“…To achieve better separation of granulocytes from erythrocytes, during apheresis the collected blood is supplemented by a sedimenting agent, usually 6% high-molecular-weight hydroxyethyl starch (HES) [6]. Because of the risk of severe itching following infusion of HES, granulocyte donations are limited to four per donor and year [6,10]. The specifications of article 9 of the German Transfusion Act (Transfusionsgesetz; TFG) must be observed regarding pretreatment of donors with G-CSF.…”

“…Its origin may be alloimmunization against HLA class I antigens or other granulocyte antigens (human neutrophil alloantigens, HNA). The frequency of alloimmunization against leukocyte antigens after repeated GC transfusion varies between 20-30% in the case of iatrogenic neutropenia and up to 80% in patients with aplastic anemia and chronic granulomatous disease [6,20,25]. In such cases of immunological refractoriness, HLAand/or granulocyte-antigen-compatible granulocytes are to be transfused.…”