Alan S Graham1, Thomas H Price, Thomas V Brogan. 1. Department of Pediatrics, Division of Pediatric Critical Care, Oregon Health and Science University, Portland, OR 97239-2901, USA. grahamal@ohsu.edu
Abstract
OBJECTIVE: To describe the clinical course of neutropenic pediatric oncology patients undergoing granulocyte transfusions (GTF). DESIGN: Retrospective chart review including all children receiving GTFs between March, 1998 and June, 2000. SETTING: Tertiary Children's Hospital and Regional Medical Center. PATIENTS: Thirteen pediatric oncology patients (age, 9 mo to 16 y) with neutropenia and proven or suspected serious infection. INTERVENTIONS: These 13 patients received a total of 14 courses of GTFs (number of transfusions per course ranged from 1 to 43, median=4.5). MEASUREMENTS AND MAIN RESULTS: Twelve of the patients had documented infections before GTF. Ten of the 14 courses (71%) were followed by survival to hospital discharge. All 5 patients who were intubated before GTF were extubated afterward. Two early deaths occurred due to invasive Aspergillus. No significant differences in monitoring laboratories were found. Ultimately, 8 of 13 (62%) patients in this group died. CONCLUSIONS: This case series documents the course of 13 septic neutropenic pediatric oncology patients who underwent a total of 14 GTF courses. GTFs were generally well tolerated with little decline in respiratory status or organ function. Short-term survival in this population was good whereas long-term outcome remains more difficult.
OBJECTIVE: To describe the clinical course of neutropenic pediatric oncologypatients undergoing granulocyte transfusions (GTF). DESIGN: Retrospective chart review including all children receiving GTFs between March, 1998 and June, 2000. SETTING: Tertiary Children's Hospital and Regional Medical Center. PATIENTS: Thirteen pediatric oncology patients (age, 9 mo to 16 y) with neutropenia and proven or suspected serious infection. INTERVENTIONS: These 13 patients received a total of 14 courses of GTFs (number of transfusions per course ranged from 1 to 43, median=4.5). MEASUREMENTS AND MAIN RESULTS: Twelve of the patients had documented infections before GTF. Ten of the 14 courses (71%) were followed by survival to hospital discharge. All 5 patients who were intubated before GTF were extubated afterward. Two early deaths occurred due to invasive Aspergillus. No significant differences in monitoring laboratories were found. Ultimately, 8 of 13 (62%) patients in this group died. CONCLUSIONS: This case series documents the course of 13 septic neutropenic pediatric oncologypatients who underwent a total of 14 GTF courses. GTFs were generally well tolerated with little decline in respiratory status or organ function. Short-term survival in this population was good whereas long-term outcome remains more difficult.
Authors: O Nikolajeva; A Mijovic; D Hess; E Tatam; P Amrolia; R Chiesa; K Rao; J Silva; P Veys Journal: Bone Marrow Transplant Date: 2015-03-30 Impact factor: 5.483