Clinical Effect of Granulocyte Transfusion Therapy in Neutropenia-Related Infection / 대한혈액학회지

ABSTRACT

BACKGROUND: After a zealous advocates of granulocyte transfusion therapy (GTX) in the 1970s and early 1980s, the use of GTX has diminished strikingly because of the several problems of GTX and the introduction of new antimicrobial agents and recombinant hematopoietic growth factors. Recently, GTX offers renewed interest because several investigators reported the transfusion efficacy of granulocytes collected by stimulating normal donors with recombinant human granulocyte-colony stimulating factor (G-CSF). METHODS: To evaluate the safety and efficacy of GTX, thirteen patients with neutropenia- related infections at Chonnam University Hospital from March 1997 to February 1998 were treated with dexamethasone- or G-CSF-stimulated granulocyte transfusions apheresed from normal donor. RESULTS: Patients received a mean number of 2.4 transfusions (range, 1-7) and a mean dose of 5.5x1010 granulocytes (range, 0.2-19.6). Six patients (46.2%) had favorable responses. Favorable responses occurred among patients with more fungal infection than bacterial infection (71.4 vs 28.6%, P<0.05) and more increment of absolute neutrophil count at 1 hour after transfusion (P<0.05). Adverse reactions of GTX were pulmonary edema in 2 patient (15.4%) and transient hypoxia in 1 patient (7.7%). One patient (7.7%) with pulmonary edema died of severe pulmonary reaction. Two of 20 donors received by G-CSF complained of mild myalgia and bone pain. CONCLUSION: G-CSF- or dexamethasone-stimulated GTXs were well tolerated and may be clinically beneficial for neutropenia-related infection, particularly in fungal infection, that is refractory to antimicrobial therapy.