Clinical outcome of granulocyte transfusion therapy for the treatment of refractory infection in neutropenic patients with hematological diseases

Abstract

Neutropenic patients with hematological diseases are prone to severe infections. Granulocyte transfusion therapy (GTX) is considered as a logical therapeutic approach for these problems. However, the efficacy and complications of GTX have not been well identified. We retrospectively analyzed the clinical outcomes of GTX therapy in our hospital from 2009 to 2015. After 117 granulocyte transfusions for 47 patients, 72.3% of these patients' infections were effectively improved, and the overall survival rates at 30 and 120 days were 66.0 and 57.5%, respectively. The patients who experienced neutrophil recovery within 10 days after their therapy initiation had a better response and long-term survival period (14/15, 93.3%, vs 20/32, 62.5%, P = 0.037). Higher-dose granulocytes (> 2.55 × 10/kg) might improve the effective rate of infection in the patients who had more than 10 days neutrophil recovery time (17/23, 73.9%, vs 3/9, 33.3%, P = 0.049). In addition, GTX benefited the patients who suffered from pulmonary bacterial infections (16/20, 80%) compared with the bloodstream infection group (7/12, 58.3%) and skin or mucous infection group (1/5, 20%). The primary data showed that GTX did not affect the incidence of graft-versus-host disease (GVHD) and cytomegalovirus viremia when patients received further HSCT treatment. Collectively, GTX was an adjunct treatment modality for severely neutropenic patients who were likely to experience hematopoietic recovery. More randomized trials are needed to verify the efficacy and complications of GTX therapy.

Clinical Experience of Granulocyte Transfusion Therapy in Pediatric Patients for Management of Neutropenia-related Infections in a Tertiary Care Center in India

“…In addition, they found in their study that granulocyte therapy benefited the patients who suffered from pulmonary bacterial infections (80%) more as compared with the bloodstream infection group (58.3%) and skin or mucous infection group (20%). 18 In our study, also 72% patients of pneumonia responded to granulocyte transfusions in comparison to 37.5% with sepsis.…”

Efficacy and safety of granulocyte transfusion in children: A single‐center experience

“…Infections are the main cause of morbidity and mortality in neutropenic patients despite the use of broad‐spectrum antimicrobial agents and supportive therapies 1 . Recombinant hematopoietic growth factors reduce the incidence of life‐threatening infections, however rising rates of multidrug‐resistant bacterial and invasive fungal infections cause complications in the immunosuppressed patients 1‐5 …”

“…Infection is the leading cause of mortality in neutropenic patient with hematologic malignancy and/or has undergone hematopoietic stem cell transplantation (HSCT) 1‐4 . Alternative treatment options may be needed for patients with infection that cannot be controlled despite the use of an appropriate antimicrobial agent 1 .…”

“…Alternative treatment options may be needed for patients with infection that cannot be controlled despite the use of an appropriate antimicrobial agent 1 . Granulocyte suspension transfusion (GTx) for those has been investigated 2,4 . Granulocytes must be both sufficient in number and functional to control infection.…”

“…The studies evaluating the efficacy of GTx are controversial 4,5,8,9 . The aim of our study was to determine the safety, efficacy, and the impact of GTx on survival in children with febrile neutropenia (FEN).…”