Résumé
PURPOSE: The use of granulocyte transfusion (GT) which had been diminished since 1980s has been recently interested on the base of clinical efficacy approved by transfusion of granulocyte collected after administration of granulocyte-colony stimulating factor (G-CSF) to donors. So we studied the clinical efficacy of GT in severe neutropenic pediatric patients with severe infections. METHODS: Twelve patients with malignant hematologic disorders and solid tumors in Ajou University Hospital from March 1997 to February 2001 were indicated for GT. These patients had continuous neutropenia-related infections despite appropriate antibiotics, antifungal or IV immunoglobulin therapy. GTs were carried out 12 hrs after collection of granulocytes using leukapheresis from donors stimulated by G-CSF. RESULTS: The median number of GT is 3 (2~7), and the mean dose of granulocyte is 3.51+/-4.21 10(10)/m(2) and mean volume of granulocyte is 220 +/-22.92 mL. The median duration of the use of G-CSF and antibiotics or antifungal agents is 6 (3~14) days and 3 (1~9) days. Ten of 12 patients had favorable responses (FR), and 2 patients had unfavorable responses (UR). Two patients who had FR died of acute respiratory distress syndrome (ARDS), complication of GT. CONCLUSION: GT is effective treatment for severe neutropenic pediatric patients with severe infections. Enough amount of granulocytes could be collected after administration of G-CSF without dexamethasone to donors. However, ARDS which is an adverse effect of GT, is considered in pulmonary compromised patients.