Use of healthy-donor granulocyte transfusions to treat infections in neutropenic patients with myeloid or lymphoid neoplasms: experience in 74 patients treated with 373 granulocyte transfusions.
OBJECTIVE
Despite limited evidence for efficacy, granulocyte transfusions (GTX) are used to prevent and treat opportunistic infections in patients with neutropenia.


METHODS
Three hundred and seventy-three GTX given to 74 patients were assessed retrospectively.


RESULTS
GTX were discontinued because of clinical improvement more often in patients with severe infections than in patients without severe infections (27 vs. 12%; p ≤ 0.002), whereas deaths resulted in discontinuation of GTX therapy less often in patients with severe infections than without (8 vs. 39%; p ≤ 0.002). Patients who died by 12 weeks after GTX initiation were more likely to have leukemia (p = 0.03), not to have recovery of neutrophil counts (p < 0.0001), and to have started GTX during a critical care unit stay (p < 0.001). Uses of granulocyte colony-stimulating factor (p ≤ 0.02) and interferon-γ (p ≤ 0.04) were more common in patients who survived. In patients with comorbidities (31%; odds ratio, OR, 12.6; 95% confidence interval, CI, 2.4-65.7; p ≤ 0.003), GTX was started in the critical care unit (OR 8.8; 95% CI 2.5-30.9; p < 0.001), and a high total bilirubin level at the end of GTX (OR 2.1; 95% CI 1.1-4.2; p = 0.03) had a higher probability of death 12 weeks after GTX therapy commenced.


CONCLUSIONS
The possibility that a niche population may benefit from GTX requires further assessment.
The University of Texas MD Anderson Cancer Center, Houston, Tex., USA.
Amar
A
Safdar
Gilhen
G
Rodriguez
Jorge
J
Zuniga
Fadi
F
Al Akhrass
Anupam
A
Pande
D000328:Adult; D005260:Female; D006098:Granulocytes / Q000637:transplantation*; D006801:Humans; D007938:Leukemia / Q000150:complications / Q000628:therapy*; D017708:Leukocyte Transfusion; D008223:Lymphoma / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000628:therapy*; D009894:Opportunistic Infections / Q000628:therapy*; D012189:Retrospective Studies