BACKGROUND/AIMS: 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.
BACKGROUND/AIMS: 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.
Authors: C P Engelfriet; H W Reesink; H G Klein; M F Murphy; D Pamphilon; S Devereux; P Höcker; D Adkins; N Boyce; S Tobin; A Grigg; R G Strauss; W C Liles; T H Price; D C Dale; F Norol Journal: Vox Sang Date: 2000 Impact factor: 2.144
Authors: Jacob M Rowe; Donna Neuberg; William Friedenberg; John M Bennett; Elisabeth Paietta; Adel Z Makary; Jane L Liesveld; Camille N Abboud; Gordon Dewald; F Ann Hayes; Martin S Tallman; Peter H Wiernik Journal: Blood Date: 2003-09-25 Impact factor: 22.113
Authors: Roy F Chemaly; Harrys A Torres; Ray Hachem; Dimitrios P Kontoyiannis; Amar Safdar; Issam I Raad Journal: Haematologica Date: 2008-01 Impact factor: 9.941
Authors: Amar Safdar; Gilhen H Rodriguez; Marcos J De Lima; Demetrios Petropoulos; Roy F Chemaly; Laura L Worth; Elizabeth J Shpall; Kenneth V I Rolston; Issam I Raad; Ka Wah Chan; Richard E Champlin Journal: Medicine (Baltimore) Date: 2007-11 Impact factor: 1.889