Effect and Safety of Granulocyte Transfusions in Pediatric Patients With Febrile Neutropenia or Defective Granulocyte Functions

Atay, Didem; Öztürk, Gülyüz; Akçay, Arzu; Yanasik, Melek; Anak, Sema; Devecioğlu, Ömer

doi:10.1097/mph.0b013e31821ffdf1

Cited by 31 publications

(30 citation statements)

References 14 publications

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“…The number of transfusion was found to be lower compared to previous five studies reporting median value of 3-8.5 (min-max 1-40) [3,[5][6][7]9]. One of the reasons for higher GTX number reported in other study by Atay and Siedel compared to our study may be the higher prevalence of fungal infection which were 24% [8] and 50% [6] respectively. Our fungal infection ratio was 5% (1/19).…”

Section: Discussioncontrasting

confidence: 82%

“…In our study, complete and partial responses were achieved up to 89.5% of neutropenic fever attacks. There were limited studies with different success rates ranging from 60% to 92% [5,[7][8][9][10][11]. Infection related mortality rate was 10.5% in our study.…”

Section: Discussioncontrasting

confidence: 43%

“…However median of ANC 24 hours after GTX was higher than baseline median ANC which was previously reported [7]. On the other hand Atay et al reported that ANC at 24 hours after GTX did not differ from baseline ANC [8].…”

Section: Discussionmentioning

confidence: 44%

“…Infection related mortality rate was 10.5% in our study. In the pediatric age groups, the mortality rates were reported ranging from 7.4% to 30.8% [3,5,7,8,12]. It should be kept in mind that both of responses to therapy and mortality rates could be affected from the primary disease, the response of primary disease, patient's individual factors, the availability of pediatric intensive care units, the causative microorganisms.…”

Section: Discussionmentioning

confidence: 94%

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Granulocyte transfusion experience in pediatric neutropenic fever: Splitted product can be an alternative?

Oymak¹,

Ayhan

Karapınar³

et al. 2015

Transfusion and Apheresis Science

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Section: Discussioncontrasting

confidence: 82%

Section: Discussioncontrasting

confidence: 43%

Section: Discussionmentioning

confidence: 44%

Section: Discussionmentioning

confidence: 94%

See 2 more Smart Citations

Granulocyte transfusion experience in pediatric neutropenic fever: Splitted product can be an alternative?

Oymak¹,

Ayhan

Karapınar³

et al. 2015

Transfusion and Apheresis Science

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“…2 Other authors also documented that GTF is generally well tolerated and short term survival was good in pediatric oncology and HSCT patients with neutropenic sepsis. 3,4,24 GTF is recommended when the absolute neutrophil count is less than 500 cells/microliter, when there is evidence of bacterial or fungal infection, unresponsiveness to aggressive antimicrobial treatment and no recovery of neutrophil count expected for more than 7 days. 25 In our study, all patients were in the high risk group.…”

Section: Discussionmentioning

confidence: 99%

Donor Granulocyte Transfusions in Febrile Neutropenic Pediatric Oncology Patients

Sezgin¹

2014

UHOD

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To describe the clinical course of febrile neutropenic pediatric oncology patients undergoing granulocyte transfusions (GTF), we performed a retrospective chart review of all pediatric oncology patients with febrile neutropenia receiving granulocyte transfusions between September 2009 and September 2011 in a University Hospital setting. Thirty-seven patients received a total of 51 courses of GTFs. In 35 febrile episodes patients had leukemia and in 16 episodes patients had solid tumors. Three patients received allogeneic hematopoietic stem cell transplantation from their HLA identical sibling. Mean duration of fever and neutropenia was 18.5±17.5 days. Infections were classified as fever of unknown origin (21%, n= 11), microbiologically documented infection (44%, n= 23), clinically suspected infection (35%, n= 18). The mean granulocyte yield, WBC count and granulocyte count of the products were 3.1±1.2x10 10 /unit, 158.6±66.4x10 3 /mm 3 and 134.5±62x 10 3 /mm 3 , respectively. The median donor WBC count at leukapheresis was 32.91x10 9 /L. GTFs were well tolerated except one patient who had fever during transfusion. Thirty-nine (76.5%) of the episodes resolved from infection and discharged from the hospital. Of the 12 patients (23.5%) who died, seven of them were refractory to treatment, three patients had relapsed disease and two patients had newly diagnosed disease. This case series documents the course of 37 septic neutropenic pediatric oncology patients who underwent a total of 51 GTF courses. GTFs were generally well tolerated and improve short-term outcome in neutropenic pediatric oncology patients. Keywords: Donor granulocyte transfusion, Febrile neutropenia, Childhood ÖZET Febril Nötropenik Pediatrik Onkoloji Hastalarında Donör Granülosit TransfüzyonlarıBu çalışmada febril nötropeni gelişen kanserli çocuk hastaların granülosit transfüzyonu sonrası klinik durumlarının izlenmesi amaçlandı. Eylül 2009 ile Eylül 2011 yılları arasında üniversite hastanesinde, nötropenik ateş nedeniyle granülosit tranfüzyonu verilen hastaların retrospektif olarak dosyaları incelenmiştir. Otuz yedi hasta toplam ellibir granülosit transfüzyonu almıştır. Febril atakların 35'inde lösemi, 16 atakta ise solid tümör tanısı mevcut idi. Üç hastaya HLA uygun kardeşten allojeneik kök hücre nakli yapılmış idi. Ortalama ateş ve nötropeni süresi 18.5±17.5 gün saptandı. Hastaların %21'inde (n= 11) sebebi bilinmeyen ateş, %44'ünde (n= 23) mikrobiyolojik olarak kanıtlanmış enfeksiyon, %35'inde (n= 18) klinik enfeksiyon vardı. Granülosit ürün verimi 3.1±1.2x10 10 /ünite, ortalama ürün beyaz küre sayısı 158.6±66.4x10 3 / mm 3 ve ortalama ürün granülosit sayısı 134.5±62x 10 3 /mm 3 bulundu. Lökaferezde vericinin ortanca beyaz küre sayısı 32.91x10 9 /L olarak saptandı. Granülosit transfüzyonları bir hastada transfüzyon sırasında gelişen ateş dışında iyi tolere edilmişti. Otuz dokuz atakta (%76.5) hastalar iyileşerek taburcu edilmiş; 12 (%23.5) atak sonrasında hasta kaybedilmiştir. Kaybedilen hastaların yedisinde refrakter hastalık, iki tanes...

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Granulocyte transfusions for treating infections in people with neutropenia or neutrophil dysfunction

Estcourt

Stanworth

Hopewell

et al. 2016

Cochrane Database of Systematic Reviews

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Background Despite modern antimicrobials and supportive therapy bacterial and fungal infections are still major complications in people with prolonged disease-related or treatment-related neutropenia. Transfusions of granulocytes have a long history of usage in clinical practice to support and treat severe infection in high-risk groups of patients with neutropenia or neutrophil dysfunction. However, there is considerable current variability in therapeutic granulocyte transfusion practice, and uncertainty about the beneficial effect of transfusions given as an adjunct to antibiotics on mortality. This is an update of a Cochrane review first published in 2005. Objectives To determine the effectiveness and safety of granulocyte transfusions compared to no granulocyte transfusions as adjuncts to antimicrobials for treating infections in people with neutropenia or disorders of neutrophil function aimed at reducing mortality and other adverse outcomes related to infection. Search methods We searched for randomised controlled trials (RCTs) in the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library 2016, Issue 2). MEDLINE (from 1946), Embase (from 1974), CINAHL (from 1937), the Transfusion Evidence Library (from 1980) and ongoing trial databases to 11 February 2016. Selection criteria RCTs comparing people with neutropenia or disorders of neutrophil dysfunction receiving granulocyte transfusions to treat infection with a control group receiving no granulocyte transfusions. Neonates are the subject of another Cochrane review and were excluded from this review. There was no restriction by outcomes examined, language or publication status. Data collection and analysis We used standard methodological procedures expected by the Cochrane Collaboration. Main results We identified 10 trials that met the inclusion criteria with a total of 587 participants. We also identified another ongoing trial. These trials were conducted between 1975 and 2015. None of the studies included people with neutrophil dysfunction. The studies differed in the type of infections they included. Six studies included both children and adults, however data were not reported separately for children and adults. The two newest studies gave granulocyte colony stimulating factor (G-CSF) to donors; both were stopped early due to lack of recruitment. Three studies re-randomised participants and therefore quantitative analysis was unable to be performed. Overall the quality of the evidence was very low to low across different outcomes according to GRADE methodology. This was due to many of the studies being at high risk of bias, and many of the outcomes being imprecise. There may be no difference in all-cause mortality over 30 days between participants receiving therapeutic granulocyte transfusions and those that did not (six studies; 321 participants; RR 0.75, 95% CI 0.54 to 1.04; very low-quality evidence). There were no differences between the granulocyte dose subgroups (< 1 x 1010 per day versus ≥ 1 x 1010 per day) (test ...

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Effect and Safety of Granulocyte Transfusions in Pediatric Patients With Febrile Neutropenia or Defective Granulocyte Functions

Abstract: GTX is safe and effective in controlling the life-threatening infections. Further randomized controlled studies with long-term follow-up are needed to assess the exact role of GTX in the outcome of patients with neutropenia and patients with defective granulocyte functions.

Cited by 31 publications

References 14 publications

Granulocyte transfusion experience in pediatric neutropenic fever: Splitted product can be an alternative?

Granulocyte transfusion experience in pediatric neutropenic fever: Splitted product can be an alternative?

Donor Granulocyte Transfusions in Febrile Neutropenic Pediatric Oncology Patients

Granulocyte transfusions for treating infections in people with neutropenia or neutrophil dysfunction

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Effect and Safety of Granulocyte Transfusions in Pediatric Patients With Febrile Neutropenia or Defective Granulocyte Functions

Abstract: GTX is safe and effective in controlling the life-threatening infections. Further randomized controlled studies with long-term follow-up are needed to assess the exact role of GTX in the outcome of patients with neutropenia and patients with defective granulocyte functions.

Cited by 31 publications

References 14 publications

Granulocyte transfusion experience in pediatric neutropenic fever: Splitted product can be an alternative?

Granulocyte transfusion experience in pediatric neutropenic fever: Splitted product can be an alternative?

Donor Granulocyte Transfusions in Febrile Neutropenic Pediatric Oncology Patients

Granulocyte transfusions for treating infections in people with neutropenia or neutrophil dysfunction

Contact Info

Product

Resources

About

Donor Granulocyte Transfusions in Febrile Neutropenic Pediatric Oncology Patients