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Survival among children and adults treated with granulocyte transfusions: Twenty years’ experience at a Brazilian blood center

  • Cesar de Almeida-Neto
    Correspondence
    Corresponding author at: Avenida Dr., Enéas Carvalho de Aguiar, 155 – 1º andar. Consolação, São Paulo, SP, 05003-000, Brazil.
    Affiliations
    Fundação Pró-Sangue - Hemocentro de São Paulo, São Paulo, SP, Brazil

    Disciplina de Hematologia, Hemoterapia e Terapia Celular da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil

    Disciplina de Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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  • Lucas Machado Corso
    Affiliations
    Disciplina de Hematologia, Hemoterapia e Terapia Celular da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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  • Lucas Bassolli
    Affiliations
    Disciplina de Hematologia, Hemoterapia e Terapia Celular da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil

    Laboratório de Investigação Médica 31 (LIM-31) – Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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  • Steven S. Witkin
    Affiliations
    Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, USA

    Institute of Tropical Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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  • Debora Toshie Hamasaki
    Affiliations
    Fundação Pró-Sangue - Hemocentro de São Paulo, São Paulo, SP, Brazil

    Disciplina de Hematologia, Hemoterapia e Terapia Celular da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
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  • André Luís Albiero
    Affiliations
    Fundação Pró-Sangue - Hemocentro de São Paulo, São Paulo, SP, Brazil
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  • Caroline Limoeiro Manangão
    Affiliations
    Fundação Pró-Sangue - Hemocentro de São Paulo, São Paulo, SP, Brazil

    Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil

    Instituto do Tratamento do Câncer Infantil, São Paulo, Brazil
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  • Alfredo Mendrone-Junior
    Affiliations
    Fundação Pró-Sangue - Hemocentro de São Paulo, São Paulo, SP, Brazil

    Laboratório de Investigação Médica 31 (LIM-31) – Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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  • Vanderson Rocha
    Affiliations
    Fundação Pró-Sangue - Hemocentro de São Paulo, São Paulo, SP, Brazil

    Disciplina de Hematologia, Hemoterapia e Terapia Celular da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil

    Laboratório de Investigação Médica 31 (LIM-31) – Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
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Published:October 26, 2021DOI:https://doi.org/10.1016/j.transci.2021.103300

      Abstract

      Background

      It remains controversial whether granulocyte transfusions as a supportive treatment improve survival in patients with febrile neutropenia or granulocyte dysfunctions. We describe survival rates subsequent to granulocyte transfusions in pediatric and adults patients treated at a major blood center in Brazil.

      Material and methods

      We retrospectively reviewed the clinical charts of pediatric and adult patients treated with granulocyte transfusions at our institution from January 2000 to October 2019. We assessed demographic characteristics, clinical features, indications for transfusion, units transfused, dose of granulocytes administered and survival rates 30 and 100 days after the initial transfusion.

      Results

      We identified 64 pediatric and 67 adult patients treated with 262 granulocyte transfusions. An optimal dose (> 0.6 × 109 granulocytes per kilogram per transfused unit) was available for transfusion in 80.4 % of pediatric patients but in only 19.6 % of adults (p = 0.017). Thirty days after their first granulocyte transfusion, 38 (59.4 %) pediatric and 61 (91 %) adult patients had died. Patients receiving the optimal dose of granulocytes had better survival outcomes, but even among this sub-group, adults were more likely to die than were children either at 30 days (OR = 8.67, 95 %CI 2.69–34.9) or 100 days (OR = 6.27, 95 %CI 1.86–25.9) after their initial granulocyte transfusion.

      Conclusion

      Survival rates following granulocyte transfusion varied by the dose transfused and were higher in children than in adults.

      Keywords

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