title: Prophylactic and interventional granulocyte transfusions in patients with haematological malignancies and life-threatening infections during neutropenia.
abstract: Patients with haematological malignancies and prolonged periods of neutropenia after chemotherapy are at high risk for severe bacterial and fungal infections. Those infections have long time been considered as a contraindication for subsequent haematopoietic stem cell transplantation (HCT). We conducted a prospective, non-randomized study of granulocyte transfusions (GTX) to control acute life-threatening infections (44 episodes) and to prevent recurrence of severe fungal infections during HCT or intensive chemotherapy (23 episodes). GTX achieved control in 82% (36/44) of acute life-threatening infections. No single reactivation of a previous infection occurred under prophylactic GTX (0/23). Median survival was 170 days in the interventional group and 185 days in the prophylactic group; death in both patient groups was mainly due to underlying progressive malignant disease. We conclude that under GTX, the infection-related mortality even in high-risk patients is low. Due to a secondary prophylaxis with GTX, haematopoietic allografts can be safely given to patients with previous fungal infections.
authors.affiliation: Department of Haematology and Oncology, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Mousset
authors.forename: Stella
authors.initials: S
authors.lastname: Hermann
authors.forename: Stefan A
authors.initials: SA
authors.lastname: Klein
authors.forename: Heike
authors.initials: H
authors.lastname: Bialleck
authors.forename: Michaele
authors.initials: M
authors.lastname: Duchscherer
authors.forename: Barbara
authors.initials: B
authors.lastname: Bomke
authors.forename: Barbara
authors.initials: B
authors.lastname: Wassmann
authors.forename: Angelika
authors.initials: A
authors.lastname: Böhme
authors.forename: Dieter
authors.initials: D
authors.lastname: Hoelzer
authors.forename: Hans
authors.initials: H
authors.lastname: Martin
mesh_terms: D000328:Adult; D000368:Aged; D001787:Blood Group Incompatibility; D001803:Blood Transfusion; D003422:Critical Care; D005260:Female; D006098:Granulocytes / Q000637:transplantation*; D019337:Hematologic Neoplasms / Q000097:blood / Q000628:therapy*; D006801:Humans; D007938:Leukemia / Q000097:blood / Q000473:pathology / Q000628:therapy; D017708:Leukocyte Transfusion; D019520:Living Donors; D008223:Lymphoma / Q000097:blood / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009503:Neutropenia / Q000628:therapy*