title: The granulocytes in neutropenia 1 (GIN 1) study: a safety study of granulocytes collected from whole blood and stored in additive solution and plasma.
abstract: OBJECTIVE
  To evaluate the safety of transfusing pooled, whole blood-derived granulocytes in additive solution and plasma (GASP) in 30 recipients.
  
  
  BACKGROUND
  Demand for granulocytes in England has increased five-fold. With the advantages of reduced red cell, plasma and overall volume, GASP maintains function in vitro.
  
  
  METHODS
  Observations were recorded prior to and post transfusion. Increments were recorded at 1 h and the following morning. Leucocyte antibody screening was undertaken prior to and at 1-6 months following transfusion.
  
  
  RESULTS
  Thirty patients aged between 8 months and 68 years received 221 GASP in 148 transfusion episodes. GASP contained an average of 1.0 × 10(10) granulocytes in 207 mL. Adults usually received two packs and children 10-20 mL kg(-1). Children and adults received a median [interquartile range (IQR)] dose of 12.5 (9.1-25.3) and 19.7 (12.0-25.8) × 10(9) granulocytes per transfusion, respectively. There was one episode of transfusion-associated circulatory overload (TACO) in a patient with chronic cardiac failure following 600 mL of unpooled granulocytes, other fluids and one GASP. New leucocyte alloimmunisation occurred in 3/30 recipients 10%. No other significant reactions were reported. Median peripheral blood neutrophil increments at 1 h post transfusion were 0.06 (IQR, 0.01-0.17) in children and (0.03) (IQR, 0-0.16) in adults.
  
  
  CONCLUSIONS
  GASP has a similar safety profile to other sources of granulocytes for patients with refractory infection or in need of secondary prophylactic transfusion. Further studies are required to clarify the role of GASP in the treatment of neutropenic patients.
authors.affiliation: NHS Blood and Transplant, North Bristol Park, Northway Filton, Bristol BS34 7QH, UK. edwin.massey@nhsbt.nhs.uk
authors.forename: Edwin
authors.initials: E
authors.lastname: Massey
authors.forename: Kay
authors.initials: K
authors.lastname: Harding
authors.forename: Brennan C
authors.initials: BC
authors.lastname: Kahan
authors.forename: Charlotte
authors.initials: C
authors.lastname: Llewelyn
authors.forename: Robert
authors.initials: R
authors.lastname: Wynn
authors.forename: John
authors.initials: J
authors.lastname: Moppett
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Robinson
authors.forename: Ann
authors.initials: A
authors.lastname: Green
authors.forename: Geoff
authors.initials: G
authors.lastname: Lucas
authors.forename: Deepak
authors.initials: D
authors.lastname: Sadani
authors.forename: Effie
authors.initials: E
authors.lastname: Liakopoulou
authors.forename: Paula
authors.initials: P
authors.lastname: Bolton-Maggs
authors.forename: David I
authors.initials: DI
authors.lastname: Marks
authors.forename: Simon
authors.initials: S
authors.lastname: Stanworth
mesh_terms: D000293:Adolescent; D000328:Adult; D001793:Blood Preservation / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004739:England; D005260:Female; D006098:Granulocytes / Q000166:cytology*; D006801:Humans; D017708:Leukocyte Transfusion / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000628:therapy*; D019999:Pharmaceutical Solutions / Q000009:adverse effects / Q000494:pharmacology; D012449:Safety
chemical_list: D019999:Pharmaceutical Solutions