title: 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.
abstract: BACKGROUND
  Feasibility, response to granulocyte transfusion therapy, and clinical outcome were compared among HPC transplant recipients enrolled in a prospective study of a community blood bank-based unrelated donors program, a prospective granulocyte study using family donors, and matched control patients without granulocyte transfusion therapy.
  
  
  METHODS
  Overall, 40 patients (327 collections) received granulocyte concentrates from unrelated donors, 34 patients (219 collections) received granulocyte concentrates from related donors, and 74 patients served as controls. Study entry criteria for patients included an absolute neutrophil count (ANC) of less than 200 per microL and documented invasive fungal or bacterial infections.
  
  
  RESULTS
  There was a median delay of 3 days (range, 0-14) in patients receiving transfusions from unrelated donors between day of diagnosis of infection and start of granulocyte transfusion therapy as compared with a median delay of 5 days (range, 0-25) in patients receiving transfusions from related donors (p = 0.01). The ANC increment after the first, second, and seventh transfusions in patients who had community donors was significantly higher or comparable to patients who had family donors. Overall, clinical outcome was comparable between the three patient groups. Kaplan-Meier analysis revealed no difference between all cohorts in overall 6-month survival (p = 0.28, log-rank) or event-free survival (p = 0.17, log-rank).
  
  
  CONCLUSIONS
  These results suggest that future efficacy trials should consider inclusion of unrelated community donors for timely institution of granulocyte transfusion therapy.
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, Washington 98109, USA.
authors.forename: Kai
authors.initials: K
authors.lastname: Hübel
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Carter
authors.forename: W Conrad
authors.initials: WC
authors.lastname: Liles
authors.forename: David C
authors.initials: DC
authors.lastname: Dale
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Price
authors.forename: Raleigh A
authors.initials: RA
authors.lastname: Bowden
authors.forename: Scott D
authors.initials: SD
authors.lastname: Rowley
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Chauncey
authors.forename: William I
authors.initials: WI
authors.lastname: Bensinger
authors.forename: Michael
authors.initials: M
authors.lastname: Boeckh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001782:Blood Donors / Q000145:classification*; D002648:Child; D002675:Child, Preschool; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D015331:Cohort Studies; D018572:Disease-Free Survival; D005190:Family; D005240:Feasibility Studies; D005260:Female; D006086:Graft vs Host Disease / Q000453:epidemiology / Q000517:prevention & control; D006098:Granulocytes; D019337:Hematologic Neoplasms / Q000401:mortality / Q000628:therapy; D006801:Humans; D007239:Infections / Q000209:etiology / Q000628:therapy*; D007958:Leukocyte Count; D017708:Leukocyte Transfusion; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome