title: Leukocyte transfusions revisited: stem cell graft stimulation in graft failure.
abstract: BACKGROUND
  The aim was to evaluate the role of leukocyte transfusions (LTX) in relation to graft function during prolonged neutropenia after stem cell transplantation (SCT).
  
  
  METHODS
  In 1989-2005, 22 SCT patients have received LTX in our unit. In all patients severe infection with profound neutropenia (<0.2 x 10(9)/L) preceded LTX. 13/22 had multi-organ failure or thrombotic microangiopathy. Irradiated leukocytes from pooled random donor products at 1.0 x 10(10) leukocytes/m(2)/day for a minimum of 3 days were used. Myeloid recovery and clinical benefit were analyzed.
  
  
  RESULTS
  Engraftment defined as an absolute neutrophil count (ANC) of >0.5 x 10(9)/L on three consecutive days was observed in 15/22 (68%) patients at median of 6 (range 2-25) days after LTX, and sustained engraftment (ANC of >0.5 x 10(9)/L for 4 weeks) in 11/22 (50%) patients. Clinical benefit was observed in 6/22 (27%) patients with a prolonged antecedent neutropenia, who still demonstrated rapid sustained engraftment after LTX. Ongoing thrombotic microangiopathy was associated with persistent graft failure.
  
  
  CONCLUSIONS
  LTX from random donors was associated with a rapid recovery of myeloid function in severely ill SCT patients. We speculate that allostimulation by LTX may have a role.
authors.affiliation: Hospital for Children and Adolescents, Hematology-Oncology and Stem Cell Transplantation, Helsinki, Finland. mervi.taskinen@hus.fi
authors.forename: Mervi
authors.initials: M
authors.lastname: Taskinen
authors.forename: Kimmo
authors.initials: K
authors.lastname: Talvensaari
authors.forename: Liisa
authors.initials: L
authors.lastname: Hovi
authors.forename: Kim
authors.initials: K
authors.lastname: Vettenranta
authors.forename: Ulla M
authors.initials: UM
authors.lastname: Saarinen-Pihkala
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006085:Graft Survival; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007223:Infant; D007958:Leukocyte Count; D017708:Leukocyte Transfusion; D008297:Male; D009503:Neutropenia / Q000209:etiology / Q000628:therapy*; D009504:Neutrophils