Granulocyte transfusion therapy of experimental Pseudomonas septicemia: study of cell dose and collection technique

Appelbaum, FR; Bowles, CA; Makuch, RW; Deisseroth, AB

doi:10.1182/blood.v52.2.323.323

Cited by 62 publications

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“…61,62 Transfusion of therapeutic granulocytes also has been shown to have survival benefits in studies of children and infants with neutropenia induced by either sepsis or chemotherapy, [63][64][65][66][67][68] while other studies found no benefit but also no evidence of harm. [69][70][71][72][73] There is also evidence in neutropenic septic canine models that granulocyte transfusions improve mortality, [74][75][76][77][78] shorten time to clearance of the offending microorganism from the bloodstream and tissues, [79][80][81][82] and decrease the risks of developing infection. 83 Our data are the first to evaluate therapeutic granulocyte transfusions in nonneutropenic subjects unable to expand circulating counts challenged with a severe infectious stimulus.…”

Section: Discussionmentioning

confidence: 99%

In canine bacterial pneumonia circulating granulocyte counts determine outcome from donor cells

et al. 2020

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BACKGROUND In experimental canine septic shock, depressed circulating granulocyte counts were associated with a poor outcome and increasing counts with prophylactic granulocyte colony‐stimulating factor (G‐CSF) improved outcome. Therapeutic G‐CSF, in contrast, did not improve circulating counts or outcome, and therefore investigation was undertaken to determine whether transfusing granulocytes therapeutically would improve outcome. STUDY DESIGN AND METHODS Twenty‐eight purpose‐bred beagles underwent an intrabronchial Staphylococcus aureus challenge and 4 hours later were randomly assigned to granulocyte (40‐100 × 109 cells) or plasma transfusion. RESULTS Granulocyte transfusion significantly expanded the low circulating counts for hours compared to septic controls but was not associated with significant mortality benefit (1/14, 7% vs. 2/14, 14%, respectively; p = 0.29). Septic animals with higher granulocyte count at 4 hours (median [interquartile range] of 3.81 3.39‐5.05] vs. 1.77 [1.25‐2.50]) had significantly increased survival independent of whether they were transfused with granulocytes. In a subgroup analysis, animals with higher circulating granulocyte counts receiving donor granulocytes had worsened lung injury compared to septic controls. Conversely, donor granulocytes decreased lung injury in septic animals with lower counts. CONCLUSION During bacterial pneumonia, circulating counts predict the outcome of transfusing granulocytes. With low but normal counts, transfusing granulocytes does not improve survival and injures the lung, whereas for animals with very low counts, but not absolute neutropenia, granulocyte transfusion improves lung function.

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Section: Discussionmentioning

confidence: 99%

In canine bacterial pneumonia circulating granulocyte counts determine outcome from donor cells

et al. 2020

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“…The minimum dose of cells required for a measurable granulocyte increment is 2-3 × 10 10 and these doses correspond to 3-4 × 10 8 granulocytes/kg in a normal 70-kg adult [3,20]. Experimental studies in neutropenic dogs with septicemia showed that no dogs survived when transfused with 10 8 granulocytes/kg, whereas 100% survived when given 2 × 10 8 granulocytes/kg [21]. Extrapolating this to humans, a 70-kg adult would require a dose of 1·4 × 10 10 granulocytes.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic transfusions of granulocytes collected by simple bag method for children with cancer and neutropenic infections: results of a single‐centre pilot study

Kikuta¹,

Ohto

Nemoto³

et al. 2006

Vox Sanguinis

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“…These phenomena have been well demonstrated in a canine model of granulocytopenia with gram-negative septicemia. 2 The model demonstrates that the success of granulocyte transfusion therapy for sepsis is clearly dependent on the dose of granulocytes transfused and the collection technique employed. In our own studies, we are pursuing both procurement methods.…”

Section: Granulocyte Transfusion and Protective Isolationmentioning

confidence: 99%

Recent developments in the supportive therapy of acute myelogenous leukemia

Levine

Deisseroth

1978

Cancer

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The prognosis for patients with AML is improving, but mortality due to bleeding and infection remains significant. HLA compatibility has been the cornerstone of matching for prophylactic platelet transfusion; while HLA matched platelets are often of benefit, we have observed that HLA matching does not reliably predict transfusion responses. The platelet migration inhibition assay is, however, consistently predictive. The matching problem may be circumvented by the use of frozen autologous platelets, which circulate and function hemostatically. In the granulocytopenic patient with de novo fever (frequently due to bacterial sepsis), the immediate empiric use of broad spectrum antibiotics is mandatory. If the marrow begins to recover from chemotherapy shortly after the onset of infection, such that the peripheral granulocyte count will approach normal within 10 days, the likelihood of survival from an episode of septicemia after antibiosis now approaches 80%. If the marrow does not recover shortly, however, the likelihood of survival with antibiosis alone is poor. In this setting, survival is improved if patients are given granulocyte transfusions in addition to antibiotics. Patients who receive chemotherapy in a laminar air-flow room (LAFR) experience fewer severe infections than do patients in a conventional ward. However, most patients who are unresponsive to initial chemotherapy remain so in spite of protection from infection. Thus, the available results do not suggest that the LAFR is likely to improve appreciably the rate or duration of remission. Using malignant lymphoma as a model, we have found that cryopreserved autologous marrow infusions can hasten hematopoietic recovery in man after high-dose chemotherapy, and earlier reconstitution may be of clinical benefit to the patient; techniques are at hand that might permit the application of this concept to AML.Cancer 42:883-894, 1978.ESPITE SIGNIFICANT IMPROVEMENT in the D complete remission induction rate of patients with acute myelogenous leukemia (AML), and the gradual prolongation of survival, most patients with AML die of their disease.14 Death is primarily due to bleeding and/ or infection, and thus the major efforts in supportive therapy have been directed toward these two complications.26 While it is true that the majority of patients die of these complications only after they have exhausted the opportunities for remission afforded by the premier chemotherapeutic regimens, it is impor-

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Granulocyte transfusion therapy of experimental Pseudomonas septicemia: study of cell dose and collection technique

Cited by 62 publications

References 0 publications

In canine bacterial pneumonia circulating granulocyte counts determine outcome from donor cells

In canine bacterial pneumonia circulating granulocyte counts determine outcome from donor cells

Therapeutic transfusions of granulocytes collected by simple bag method for children with cancer and neutropenic infections: results of a single‐centre pilot study

Recent developments in the supportive therapy of acute myelogenous leukemia

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