title: Granulocyte transfusion experience in pediatric neutropenic fever: Splitted product can be an alternative?
abstract: The granulocyte transfusion (GTX) has been used for a long time due to uncontrolled neutropenic fever with antimicrobial agents. In some cases, the product needs to be splitted for using in the next 12 hours. The aim of this study is to evaluate the efficacy of splitted product and clinical response to GTX. In this study, 15 patients with malignancy with 19 neutropenic fever, who had received 56 GTX, were included. Seventeen of 56 GTX were splitted and used in maximum 12 hours during infections which did not respond to antibacterial and antifungal therapy in 7 days. The patients were divided in to response groups as a complete, partial and progressive. The predictive factors for response group were evaluated. GTX were well tolerated in all patients. The median granulocyte dose was 1.26 (0.38-5.22) × 10(9)/kg. Total response rate was 89.5%. The infection-related mortality rate was 10.5%. Although the granulocyte doses are the same in both of the product groups, an hour later ANC increment of primer product was higher than that of splitted product (p = 0.001). Among the products, 48.7% of primer product and 17.6% of splitted product had induced ≥ 1000/mm(3) ANC increment after an hour (p = 0.039). Granulocyte transfusion is safe and effective in controlling the febrile neutropenia attack. GTX should be applied in a short time to provide effective ANC increment. For now, main granulocyte product instead of splitted product should be preferred in case of uncontrolled neutropenic fever with antibacterial/antifungal agents.
authors.affiliation: Clinic of Hematology, Dr. BehcetUz Children's Hospital, 35210 Izmir, Turkey. Electronic address: yesimoymak@hotmail.com.
authors.forename: Yesim
authors.initials: Y
authors.lastname: Oymak
authors.affiliation: Blood Bank, Dr. Behcet Uz Children's Hospital, 35210 Izmir, Turkey.
authors.forename: Yüce
authors.initials: Y
authors.lastname: Ayhan
authors.affiliation: Clinic of Hematology, Dr. BehcetUz Children's Hospital, 35210 Izmir, Turkey.
authors.forename: Tuba Hilkay
authors.initials: TH
authors.lastname: Karapinar
authors.affiliation: Clinic of Infectious Disease, Dr. Behcet Uz Children's Hospital, 35210 Izmir, Turkey.
authors.forename: Ilker
authors.initials: I
authors.lastname: Devrim
authors.affiliation: Clinic of Hematology, Dr. BehcetUz Children's Hospital, 35210 Izmir, Turkey.
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Ay
authors.affiliation: Blood Bank, Dr. Behcet Uz Children's Hospital, 35210 Izmir, Turkey.
authors.forename: Hafize
authors.initials: H
authors.lastname: Sarihan
authors.affiliation: Clinic of Hematology, Dr. BehcetUz Children's Hospital, 35210 Izmir, Turkey.
authors.forename: Canan
authors.initials: C
authors.lastname: Vergin
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000935:Antifungal Agents / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D005334:Fever / Q000097:blood / Q000401:mortality / Q000628:therapy*; D006098:Granulocytes / Q000637:transplantation*; D006801:Humans; D007223:Infant; D007239:Infections / Q000097:blood / Q000401:mortality / Q000628:therapy*; D017708:Leukocyte Transfusion; D008297:Male; D009369:Neoplasms / Q000097:blood / Q000401:mortality / Q000628:therapy; D009503:Neutropenia / Q000097:blood / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents
keywords: Granulocyte transfusion; Neutropenic fever; Split