Granulocyte concentrates from a single high-yield apheresis can be split to support multiple patients.
Allogeneic granulocyte transfusion has evolved into a viable therapeutic option for immunocompromised severely neutropenic leukemic patients and those with hematopoietic stem cell transplant with life-threatening bacterial and fungal infections. The collection of larger cell doses of granulocyte concentrates (GCs) has been facilitated by the stimulation of donors with granulocyte colony stimulating factor (G-CSF) and dexamethasone. The synergistic effect of G-CSF and dexamethasone has allowed the collection of larger cell doses of GCs and its use has increased steadily. This has allowed us to split the high-yield GC products and facilitated distribution of the split GC products to a second or third patient who needs GCs but lacks donors. The main objective of this article was to present our rationale for splitting GC products and how the split GC units were transfused to multiple patients. We believe that split GCs are as equally effective as unsplit GCs and that multiple patients benefit from splitting GCs.
Department of Laboratory Medicine, The University of Texas M. D. Anderson Cancer Center , Houston, TX , USA.
Fleur M
FM
Aung
Benjamin
B
Lichtiger
Roland L
RL
Bassett
Chitra
C
Hosing
Emil J
EJ
Freireich
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000494:pharmacology; D001782:Blood Donors / Q000706:statistics & numerical data; D003907:Dexamethasone / Q000494:pharmacology*; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology*; D006098:Granulocytes / Q000166:cytology / Q000187:drug effects* / Q000637:transplantation; D019337:Hematologic Neoplasms / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D007937:Leukapheresis / Q000379:methods*; D007958:Leukocyte Count; D017708:Leukocyte Transfusion / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D000893:Anti-Inflammatory Agents; D016179:Granulocyte Colony-Stimulating Factor; D003907:Dexamethasone
Granulocytes; infectious complications; leukemia; stem cell transplant; transfusions