Sustained post-transfusion granulocyte count increments following transfusion of leukocytes obtained from donors with chronic myelogenous leukemia.
Leukocyte transfusions from patients with chronic myelogenous leukemia (CML) and elevated WBC counts were given to 14 patients with acute leukemia for the treatment of 16 infectious episodes. The WBCs were not irradiated to determine if engraftment with production of granulocytes would occur following infusion of immature myeloid elements. No recipient was alloimmunized by clinical and serologic criteria. High leukocyte yields were obtained using a variety of differential centrifugation techniques with a mean WBC yield/transfusion of 95 X 10(9) (range 19-275). A mean of 2.5 transfusions (range 1-11) were administered/recipient with a mean total dose of 235 X 10(9) WBC/transfusion episode (range 50-590). Seven patients had granulocyte counts greater than 500/microliters for four or more days (range 4-11 days) following the last transfusion. Ph1 chromosomes were documented in 2 of 4 patients tested 2-8 days following transfusion. Leukocyte alkaline phosphatase scores were increased (greater than 150) in 5/5 recipients tested post-transfusion demonstrating that production of this enzyme can be induced in CML granulocytes. Except for one severe transfusion reaction, there were no significant side effects and no recipient developed signs of graft versus host disease. All patients with sustained increments demonstrated rapid clinical improvement including 3 severely infected, poor risk patients undergoing initial induction therapy. These 3 patients all achieved complete remission with no evidence of the Ph1 chromosome. Because of the high dose of WBC which can be collected and the salutary effect of continued leukocyte production, CML WBC may be the preparation of choice for selected, non-alloimmunized, severely infected patients.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001803:Blood Transfusion / Q000379:methods*; D002904:Chromosomes, Human, 21-22 and Y; D005260:Female; D006801:Humans; D007951:Leukemia, Myeloid / Q000097:blood* / Q000235:genetics; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D007958:Leukocyte Count; D017708:Leukocyte Transfusion; D007962:Leukocytes / Q000201:enzymology; D008297:Male; D008875:Middle Aged
D000469:Alkaline Phosphatase