title: Efficacy and safety of G-CSF mobilized granulocyte transfusions in four neutropenic children with sepsis and invasive fungal infection.
abstract: BACKGROUND
  Bacterial and fungal infections are serious complications of cancer therapy. Especially during longstanding neutropenia, patients are at risk for life-threatening infections. The aim of this study was to assess the effect and safety of G-CSF mobilized granulocyte transfusions (GTX) in four neutropenic pediatric patients with sepsis.
  
  
  METHODS
  The patients were between 4.6-17.5 years old and their diagnoses included very severe aplastic anemia, non-Hodgkin's lymphoma (NHL) and acute myeloid leukemia. Before GTX, all patients had fever despite antibiotic and antimycotic therapy, neutropenia (absolute neutrophil count ANC < 500/microl), increasing C-reactive protein (CRP) values, hypotension requiring dopamine infusion and three patients needed supplemental oxygen. The granulocyte donors received G-CSF (Neupogen, 5 microg/kg body weight) 12 h prior to granulocyte apheresis.
  
  
  RESULTS
  In total, 40 GTX were performed (range 2-28 per patient). The mean increase of the granulocyte count 1 h after GTX was 1,310/microl (range 200-2,950/microl). Within the period of GTX the CRP values decreased in all patients. During or 24 h after the last GTX, the hypotension resolved and supplemental oxygen was stopped. One GTX was discontinued because of oxygen desaturation.
  
  
  CONCLUSIONS
  GTX were a safe therapeutic measure with beneficial effects on serious infections in neutropenic children.
authors.affiliation: Dept. of Pediatric Hematology and Oncology, Children's Hospital, Medical School of Hannover, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany. lorenz.grigull@gmx.de
authors.forename: L
authors.initials: L
authors.lastname: Grigull
authors.forename: A
authors.initials: A
authors.lastname: Schrauder
authors.forename: A
authors.initials: A
authors.lastname: Schmitt-Thomssen
authors.forename: K
authors.initials: K
authors.lastname: Sykora
authors.forename: K
authors.initials: K
authors.lastname: Welte
mesh_terms: D000293:Adolescent; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D002675:Child, Preschool; D016638:Critical Illness; D017809:Fatal Outcome; D005260:Female; D005500:Follow-Up Studies; D016469:Fungemia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000009:adverse effects; D019337:Hematologic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D009503:Neutropenia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D016179:Granulocyte Colony-Stimulating Factor