Granulocyte transfusions in critically ill children with prolonged neutropenia: side effects and survival rates from a single-center analysis

Weingarten, Christina; Pliez, Sarah; Tschiedel, Eva; Grasemann, Corinna; Kreissig, Carla; Schündeln, Michael M.

doi:10.1007/s00431-016-2774-y

Cited by 9 publications

(8 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a study evaluating 35 neutropenic children, Atay et al reported the 30‐ and 90‐day survival rates of 77.1% and 65.7%, respectively 15 . Weingarten et al reported 28‐ and 100‐day survival after GTx as 71.4% and 61.9%, respectively 13 . In our study, cumulative 1‐month survival rate was 87.8% and 3‐month survival rate was 76.5%.…”

Section: Discussionsupporting

confidence: 56%

“…Indications for GTx in neutropenic children are usually proven gram‐negative sepsis and fungal infections 1 . Other than patients with hematologic malignancy, GTx can also be used in patients with aplastic anemia, HLH, and in neutropenic HSCT recipients 11‐13 . The effectiveness of GTx is evaluated based on hematologic and clinical response.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Kağızmanlı

Güzelküçük

Işık

et al. 2020

J of Clinical Apheresis

View full text Add to dashboard Cite

Background Granulocyte suspension transfusion (GTx) can be used in severely neutropenic patients with infections that cannot be controlled despite appropriate antibiotic therapy. Objective We aimed to evaluate the effectiveness and safety of GTx for the treatment of febrile neutropenia (FEN) in the pediatric age group. Methods Patients who underwent GTx in the Hematology Clinic of Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital between 2013 and 2017 were evaluated retrospectively. Hematologic and clinical response rates, effects on survival, and adverse effects were investigated. Clinical response was defined at two time points: clinical response I was evaluated after each transfusion, while clinical response II was evaluated after the final GTx in a FEN episode. Results During the study period, 343 GTx were given 107 FEN episodes of 74 patients. The mean number of granulocyte suspensions administered per patient and per FEN episode was 4.6 units and 3.2 units. The mean GTx volume administered was 237 ± 40 mL, and the mean granulocyte count was 2.8 ± 1.3 x 1010/unit. Hematologic response was attained in 163 (47.6%) of 343 transfusions. Clinical response I was obtained in 88 (25.7%) of the GTx, and clinical response II was attained in 83 (78.5%) of 107 episodes. Life‐threatening adverse event was not observed. The cumulative 1‐month and 3‐month survival rates were 87.8% and 76.5%, respectively. Conclusion High hematologic response and clinical recovery rates were achieved with GTx, with no limiting adverse effects. Granulocyte transfusion appears to be a safe and effective treatment in pediatric patients with FEN.

show abstract

Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

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

Kağızmanlı

Güzelküçük

Işık

et al. 2020

J of Clinical Apheresis

View full text Add to dashboard Cite

show abstract

“…One of the most plausible parameters that predict the success of granulocyte transfusions is the granulocyte dose that is applied per time. Other possible markers for a successful infection control with granulocyte transfusions are the type of infection, organ dysfunction, and age 8,10–16…”

mentioning

confidence: 99%

“…Other possible markers for a successful infection control with granulocyte transfusions are the type of infection, organ dysfunction, and age. 8,[10][11][12][13][14][15][16] Prospective and controlled trials are difficult to conduct. 4,5,8,9,18 Single center studies are biased by mixed patient groups with various underlying diseases in a limited number of patients.…”

mentioning

confidence: 99%

“…Recent randomized trials failed to demonstrate an unequivocal benefit for granulocyte transfusions but were likely underpowered 8,9. However, as is the case for some retrospective series,7,10–17 the most recent randomized trials revealed a dose-response relation, indicating some activity of granulocyte transfusions. Many authors of case series and reviews conclude that granulocyte transfusions show a benefit for some patient groups.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Cui Bono? Identifying Patient Groups That May Benefit From Granulocyte Transfusions in Pediatric Hematology and Oncology

Johann

Wuchter

Trojanova

et al. 2021

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

Introduction: Granulocyte transfusions have long been used to bridge the time to neutrophil recovery in patients with neutropenia and severe infection. Recent randomized controlled trials did not prove a beneficial effect of granulocyte transfusions, but were likely underpowered and suffered from very heterogeneous study populations. Methods: We retrospectively reviewed data of all patients treated with granulocyte transfusions at our pediatric center from 2004 to 2019. To identify parameters that predict the success of granulocyte transfusions, we stratified patients in 3 groups. Patients in group 1 cleared their infection, whereas patients in group 2 succumbed to an infection in neutropenia despite granulocyte transfusions. A third group included all patients who died of causes that were not related to infection. Results: We demonstrate that patients without respiratory or cardiocirculatory insufficiency are enriched in group 1 and more likely to benefit from granulocyte transfusions than patients who already require these intensive care measures. The effect of granulocyte transfusions correlates with the cell dose per body weight applied per time. With our standard twice weekly dosing, patients with a body weight below 40 kg are more likely to achieve a sufficient leukocyte increment and clear their infection in comparison to patients with a higher body weight. Discussion/Conclusions: We suggest that future studies on the benefits of granulocyte transfusions stratify patients according to clinical risk factors that include the need for respiratory or cardiocirculatory support and strive for a sufficient dose density of granulocyte transfusions.

show abstract

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

et al. 2018

View full text Add to dashboard Cite

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.

show abstract

Granulocyte transfusions in critically ill children with prolonged neutropenia: side effects and survival rates from a single-center analysis

Cited by 9 publications

References 33 publications

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

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

Cui Bono? Identifying Patient Groups That May Benefit From Granulocyte Transfusions in Pediatric Hematology and Oncology

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

Contact Info

Product

Resources

About