Abstract
Active infection at the time of allogeneic hematopoietic stem cell transplantation
(HSCT) is a risk for non-relapse mortality (NRM) after HSCT. Granulocyte transfusion
(GTX) has been used to prevent or treat life-threatening infections in patients with
severe neutropenia. However, data are limited on the clinical benefits of GTX during
HSCT. We retrospectively analyzed the transplant outcomes of HSCT patients who had
undergone GTX between 2012 and 2020. Altogether, 20 patients with documented infection
had received 55 GTXs during HSCT. No adverse events were observed during the GTX infusion.
The average number of granulocytes was 0.40 (range, 0.10–1.59) × 109/kg. The median neutrophil increment one day after GTX was 515 (range, −6 to 6630)/μl,
which was significantly correlated with the infused granulocyte dose (p = 0.0007).
A total of 17 of 20 patients achieved neutrophil engraftment. The number of infused
granulocytes tended to higher in clinical responders (p = 0.12), and patients receiving
≥ 0.5 × 109/kg showed trend toward to better transplant outcomes (GTX-high vs. GTX-low, 1-year
OS; 33% vs. 11%, p = 0.19. 1-year NRM; 44% vs.77%, p = 0.11). The type of red blood
sedimenting agents was significantly correlated with the amounts of granulocyte collection.
In conclusion, GTX, especially with a high amount of containing granulocytes, could
be a safe bridging therapy for neutrophil engraftment after HSCT in patients with
active infection.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Transfusion and Apheresis ScienceAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Hematopoietic stem-cell transplantation.N Engl J Med. 2006; 354: 1813-1826
- Changes in incidence and causes of non-relapse mortality after allogeneic hematopoietic cell transplantation in patients with acute leukemia/myelodysplastic syndrome: an analysis of the Japan Transplant Outcome Registry.Bone Marrow Transplant. 2013; 48: 529-536
- Normal granulocyte transfusion therapy: treatment of septicemia due to gram-negative bacteria.N Engl J Med. 1972; 287: 367-371
- Filtration leukapheresis for granulocyte transfusion therapy. Clinical and laboratory studies.N Engl J Med. 1975; 292: 761-766
- Normal granulocyte transfusion therapy: treatment of septicemia due to gram-negative bacteria.N Engl J Med. 1972; 287: 367-371
- Granulocyte transfusion therapy for infections in candidates and recipients of HPC transplantation: a comparative analysis of feasibility and outcome for community donors versus related donors.Transfusion. 2002; 42: 1414-1421
- A comparative trial of granulocyte-colony-stimulating factor and dexamethasone, separately and in combination, for the mobilization of neutrophils in the peripheral blood of normal volunteers.Transfusion. 1997; 37: 182-187
- Granulocyte transfusions for treating infections in people with neutropenia or neutrophil dysfunction.Cochrane Database Syst Rev. 2016; 4Cd005339
- The use of stimulated granulocyte transfusions to prevent recurrence of past severe infections after allogeneic stem cell transplantation.Br J Haematol. 2003; 123: 114-118
- Randomized phase III study of granulocyte transfusions in neutropenic patients.Bone Marrow Transplant. 2008; 42: 679-684
- Efficacy of transfusion with granulocytes from G-CSF/dexamethasone-treated donors in neutropenic patients with infection.Blood. 2015; 126: 2153-2161
- Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT.Blood. 2005; 106: 2912-2919
- Primary graft failure after myeloablative allogeneic hematopoietic cell transplantation for hematologic malignancies.Leukemia. 2015; 29: 1754-1762
- Phase I/II trial of neutrophil transfusions from donors stimulated with G-CSF and dexamethasone for treatment of patients with infections in hematopoietic stem cell transplantation.Blood. 2000; 95: 3302-3309
- Single-donor granulocyte transfusions for improving the outcome of high-risk pediatric patients with known bacterial and fungal infections undergoing stem cell transplantation: a 10-year single-center experience.Bone Marrow Transplant. 2015; 50: 846-849
- Blood consult: granulocyte transfusions to treat invasive aspergillosis in a patient with severe aplastic anemia awaiting mismatched hematopoietic progenitor cell transplantation.Blood. 2012; 119: 1353-1355
- Effect of leukocyte compatibility on neutrophil increment after transfusion of granulocyte colony-stimulating factor-mobilized prophylactic granulocyte transfusions and on clinical outcomes after stem cell transplantation.Blood. 2000; 95: 3605-3612
- Transfusions of granulocyte-colony-stimulating factor-mobilized granulocyte components to allogeneic transplant recipients: analysis of kinetics and factors determining posttransfusion neutrophil and platelet counts.Transfusion. 1997; 37: 737-748
- Revision and update of the consensus definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer and the Mycoses Study Group Education and Research Consortium.Clin Infect Dis. 2020; 71: 1367-1376
- Consensus conference on acute GVHD grading.Bone Marrow Transplant. 1994; 1995: 825-828
- Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016.Intensive Care Med. 2017; 43: 304-377
- Clinical outcome of granulocyte transfusion therapy for the treatment of refractory infection in neutropenic patients with hematological diseases.Ann Hematol. 2018; 97: 2061-2070
- Allogeneic stem cell transplantation as treatment for heavily treated, refractory acute graft-versus-host disease after HLA-mismatched stem cell transplantation.Exp Hematol. 2011; 39: 880-890
- Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group.Clin Infect Dis. 2008; 46: 1813-1821
- Impact of the mobilization regimen and the harvesting technique on the granulocyte yield in healthy donors for granulocyte transfusion therapy.Transfusion. 2012; 52: 2646-2652
- Granulocyte transfusions: a critical reappraisal.Biol Blood Marrow Transplant. 2017; 23: 2034-2041
- Hydroxyethyl starch 130/0.42 versus Ringer's acetate in severe sepsis.N Engl J Med. 2012; 367: 124-134
- Hydroxyethyl starch or saline for fluid resuscitation in intensive care.N Engl J Med. 2012; 367: 1901-1911
- Impact of hydroxyethyl starch and modified fluid gelatin on granulocyte phenotype and function.Transfusion. 2019; 59: 2121-2130
- Successful granulocyte apheresis using medium molecular weight hydroxyethyl starch.Int J Hematol. 2019; 110: 729-735
Article info
Publication history
Published online: May 10, 2022
Accepted:
May 3,
2022
Received in revised form:
March 23,
2022
Received:
December 10,
2021
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
