title: Granulocyte transfusion combined with granulocyte colony stimulating factor in severe infection patients with severe aplastic anemia: a single center experience from China.
abstract: OBJECTIVE
  To investigate the efficacy and safety of granulocyte transfusion combined with granulocyte colony stimulating factor (G-CSF) in severe infection patients with severe aplastic anemia (SAA).
  
  
  METHODS
  Fifty-six patients in severe infections with SAA who had received granulocyte transfusions combined with G-CSF from 2006 to 2012 in our department were analyzed. A retrospective analysis was undertaken to investigate the survival rates (at 30 days, 90 days and 180 days), the responses to treatment (at 7 days and 30 days, including microbiological, radiographic and clinical responses), the neutrophil count and adverse events after transfusion.
  
  
  RESULTS
  All SAA patients with severe infections were treated with granulocyte transfusions combined with G-CSF. Forty-seven patients had received antithymocyte globulin/antilymphocyte globulin and cyclosporine A as immunosuppressive therapy. The median number of granulocyte components transfused was 18 (range, 3-75). The survival at 30 days, 90 days and 180 days were 50(89%), 39(70%) and 37(66%) respectively. Among 31 patients who had invasive fungal infections, the survival at 30 days, 90 days and 180 days were 27(87%), 18(58%) and 16(52%) respectively. Among the 25 patients who had refractory severe bacterial infections, the survival at 30 days, 90 days and 180 days were 23(92%), 21(84%) and 21(84%) respectively. Survival rate was correlated with hematopoietic recovery. Responses of patients at 7 and 30 days were correlated with survival rate. Common adverse effects of granulocyte transfusion included mild to moderate fever, chills, allergy and dyspnea.
  
  
  CONCLUSIONS
  Granulocyte transfusions combined with G-CSF could be an adjunctive therapy for treating severe infections of patients with SAA.
authors: Department of Hematology, General Hospital, Tianjin Medical University, Tianjin, China.
authors: Huaquan
authors: H
authors: Wang
authors: Department of Hematology, General Hospital, Tianjin Medical University, Tianjin, China.
authors: Yuhong
authors: Y
authors: Wu
authors: Department of Hematology, General Hospital, Tianjin Medical University, Tianjin, China.
authors: Rong
authors: R
authors: Fu
authors: Department of Hematology, General Hospital, Tianjin Medical University, Tianjin, China.
authors: Wen
authors: W
authors: Qu
authors: Department of Hematology, General Hospital, Tianjin Medical University, Tianjin, China.
authors: Erbao
authors: E
authors: Ruan
authors: Department of Hematology, General Hospital, Tianjin Medical University, Tianjin, China.
authors: Guojin
authors: G
authors: Wang
authors: Department of Hematology, General Hospital, Tianjin Medical University, Tianjin, China.
authors: Hong
authors: H
authors: Liu
authors: Department of Hematology, General Hospital, Tianjin Medical University, Tianjin, China.
authors: Jia
authors: J
authors: Song
authors: Department of Hematology, General Hospital, Tianjin Medical University, Tianjin, China.
authors: Limin
authors: L
authors: Xing
authors: Department of Hematology, General Hospital, Tianjin Medical University, Tianjin, China.
authors: Jing
authors: J
authors: Guan
authors: Department of Hematology, General Hospital, Tianjin Medical University, Tianjin, China.
authors: Lijuan
authors: L
authors: Li
authors: Department of Hematology, General Hospital, Tianjin Medical University, Tianjin, China.
authors: Chunyan
authors: C
authors: Liu
authors: Department of Hematology, General Hospital, Tianjin Medical University, Tianjin, China.
authors: Zonghong
authors: Z
authors: Shao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000741:Anemia, Aplastic / Q000150:complications*; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D001424:Bacterial Infections / Q000150:complications* / Q000628:therapy*; D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006098:Granulocytes / Q000166:cytology / Q000378:metabolism; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017708:Leukocyte Transfusion / Q000379:methods; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000150:complications* / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
chemical_list: D000961:Antilymphocyte Serum; D007166:Immunosuppressive Agents; D016179:Granulocyte Colony-Stimulating Factor; D016572:Cyclosporine