title: Granulocyte-colony-stimulating factor-mobilized prophylactic granulocyte transfusions given after allogeneic peripheral blood progenitor cell transplantation result in a modest reduction of febrile days and intravenous antibiotic usage.
abstract: BACKGROUND
  It was hypothesized that transfusion of two granulocyte-colony-stimulating factor (G-CSF)-mobilized prophylactic granulocyte components into allogeneic peripheral blood progenitor cell (PBPC) transplant patients during the regimen-related neutropenic interval would result in clinical benefit.
  
  
  METHODS
  HLA-matched sibling PBPC donors (n=151) were biologically randomized based on ABO mismatch to donate granulocyte components (Cohort G) or not donate granulocytes (control group, Cohort C). ABO-matched donors who did not meet other study-specific criteria were reassigned to Cohort C.
  
  
  RESULTS
  Feasibility, defined as the proportion of ABO-matched donors who underwent granulocyte collections, was 42 percent (53 of 125). The percentage of patients who developed fever during the initial hospitalization was greater in Cohort C versus Cohort G (82.7% vs. 64.2%; p=0.03). In the interval from when granulocyte transfusions were initially given in Cohort G (Day +3 or Day +5) until neutrophil engraftment, the number of febrile days was less in Cohort G versus Cohort C (median, 0 vs. 1; Mann-Whitney p=0.003). The median number of days of intravenous antibiotics given during the initial hospitalization was less in Cohort G versus Cohort C (9 vs. 11; Mann-Whitney p=0.03), a difference accounted for in the interval from Day +3 or Day +5 to neutrophil recovery. There was no significant difference in length of the initial hospital stay, acute graft-versus-host disease rates, or 100-day survival between the two cohorts.
  
  
  CONCLUSIONS
  This prospective study demonstrates a modest, but significant, benefit of G-CSF-mobilized HLA-matched prophylactic granulocyte transfusions in neutropenic allogeneic PBPC recipients.
authors.affiliation: Department of Internal Medicine, Division of Oncology, Barnes Jewish Hospital, Washington University School of Medicine, and Siteman Cancer Center, St. Louis, Missouri 63110-1093, USA.
authors.forename: Aarti
authors.initials: A
authors.lastname: Oza
authors.forename: Chris
authors.initials: C
authors.lastname: Hallemeier
authors.forename: Lawrence
authors.initials: L
authors.lastname: Goodnough
authors.forename: Hanna
authors.initials: H
authors.lastname: Khoury
authors.forename: Shalini
authors.initials: S
authors.lastname: Shenoy
authors.forename: Steven
authors.initials: S
authors.lastname: Devine
authors.forename: Kristan
authors.initials: K
authors.lastname: Augustin
authors.forename: Ravi
authors.initials: R
authors.lastname: Vij
authors.forename: Kathryn
authors.initials: K
authors.lastname: Trinkaus
authors.forename: John F
authors.initials: JF
authors.lastname: Dipersio
authors.forename: Douglas
authors.initials: D
authors.lastname: Adkins
mesh_terms: D000017:ABO Blood-Group System; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D005260:Female; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000008:administration & dosage*; D006098:Granulocytes / Q000637:transplantation*; D006650:Histocompatibility Testing; D006801:Humans; D007275:Injections, Intravenous; D017708:Leukocyte Transfusion; D008232:Lymphoproliferative Disorders / Q000150:complications / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D036102:Peripheral Blood Stem Cell Transplantation; D011446:Prospective Studies; D020127:Recovery of Function; D018805:Sepsis / Q000517:prevention & control; D014184:Transplantation, Homologous
chemical_list: D000017:ABO Blood-Group System; D000900:Anti-Bacterial Agents; D016178:Granulocyte-Macrophage Colony-Stimulating Factor