Sameer S Kadri1, Kenneth E Remy1, Jeffrey R Strich2, Juan Gea-Banacloche3, Susan F Leitman4. 1. Department of Critical Care Medicine, NIH Clinical Center, National Institutes of Health. 2. Department of Internal Medicine, MedStar-Georgetown University Hospital, Washington, DC. 3. National Cancer Institute, Experimental Transplantation and Immunology Branch, National Institutes of Health. 4. Department of Transfusion Medicine, NIH Clinical Center, National Institutes of Health, Bethesda, Maryland.
Abstract
BACKGROUND: Invasive Fusarium infection is relatively refractory to available antifungal agents. Invasive fusariosis (IF) occurs almost exclusively in the setting of profound neutropenia and/or systemic corticosteroid use. Treatment guidelines for IF are not well established, including the role of granulocyte transfusions (GTs) to counter neutropenia. STUDY DESIGN AND METHODS: We conducted a systematic review, identifying IF cases where GTs were used as adjunctive therapy to antifungal agents and also report a single-center case series detailing our experience (1996-2012) of all IF cases treated with antifungal agents and GTs. In the systematic review cases, GTs were predominantly collected from nonstimulated donors whereas, in the case series, they were universally derived from dexamethasone- and granulocyte-colony-stimulating factor-stimulated donors. RESULTS: Twenty-three patients met inclusion criteria for the systematic review and 11 for the case series. Response rates after GTs were 30 and 91% in the review and case series, respectively. Survival to hospital discharge remained low at 30 and 45%, respectively. Ten patients in the systematic review and three in the case series failed to achieve hematopoietic recovery and none of these survived. In the case series, donor-stimulated GTs generated mean "same-day" neutrophil increments of 3.35 × 10(9) ± 1.24 × 10(9) /L and mean overall posttransfusion neutrophil increments of 2.46 × 10(9) ± 0.85 × 10(9) /L. Progressive decrements in neutrophil response to GTs in two cases were attributed to GT-related HLA alloimmunization. CONCLUSION: In patients with IF, donor-stimulated GTs may contribute to high response rates by effectively bridging periods of neutropenia or marrow suppression. However, their utility in the absence of neutrophil recovery remains questionable. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.
BACKGROUND: Invasive Fusariuminfection is relatively refractory to available antifungal agents. Invasive fusariosis (IF) occurs almost exclusively in the setting of profound neutropenia and/or systemic corticosteroid use. Treatment guidelines for IF are not well established, including the role of granulocyte transfusions (GTs) to counter neutropenia. STUDY DESIGN AND METHODS: We conducted a systematic review, identifying IF cases where GTs were used as adjunctive therapy to antifungal agents and also report a single-center case series detailing our experience (1996-2012) of all IF cases treated with antifungal agents and GTs. In the systematic review cases, GTs were predominantly collected from nonstimulated donors whereas, in the case series, they were universally derived from dexamethasone- and granulocyte-colony-stimulating factor-stimulated donors. RESULTS: Twenty-three patients met inclusion criteria for the systematic review and 11 for the case series. Response rates after GTs were 30 and 91% in the review and case series, respectively. Survival to hospital discharge remained low at 30 and 45%, respectively. Ten patients in the systematic review and three in the case series failed to achieve hematopoietic recovery and none of these survived. In the case series, donor-stimulated GTs generated mean "same-day" neutrophil increments of 3.35 × 10(9) ± 1.24 × 10(9) /L and mean overall posttransfusion neutrophil increments of 2.46 × 10(9) ± 0.85 × 10(9) /L. Progressive decrements in neutrophil response to GTs in two cases were attributed to GT-related HLA alloimmunization. CONCLUSION: In patients with IF, donor-stimulated GTs may contribute to high response rates by effectively bridging periods of neutropenia or marrow suppression. However, their utility in the absence of neutrophil recovery remains questionable. Published 2015. This article is a U.S. Government work and is in the public domain in the USA.
Authors: Karen Quillen; Edward Wong; Phillip Scheinberg; Neal S Young; Thomas J Walsh; Colin O Wu; Susan F Leitman Journal: Haematologica Date: 2009-12 Impact factor: 9.941
Authors: Marcio Nucci; Elias J Anaissie; Flavio Queiroz-Telles; Carlos A Martins; Plínio Trabasso; Cristiana Solza; Claudia Mangini; Belinda P Simões; Arnaldo L Colombo; Jorge Vaz; Carlos E Levy; Silvia Costa; Vaneusa A Moreira; José Salvador Oliveira; Nestor Paraguay; Gisele Duboc; Julio C Voltarelli; Angelo Maiolino; Ricardo Pasquini; Cármino A Souza Journal: Cancer Date: 2003-07-15 Impact factor: 6.860
Authors: Ben De Pauw; Thomas J Walsh; J Peter Donnelly; David A Stevens; John E Edwards; Thierry Calandra; Peter G Pappas; Johan Maertens; Olivier Lortholary; Carol A Kauffman; David W Denning; Thomas F Patterson; Georg Maschmeyer; Jacques Bille; William E Dismukes; Raoul Herbrecht; William W Hope; Christopher C Kibbler; Bart Jan Kullberg; Kieren A Marr; Patricia Muñoz; Frank C Odds; John R Perfect; Angela Restrepo; Markus Ruhnke; Brahm H Segal; Jack D Sobel; Tania C Sorrell; Claudio Viscoli; John R Wingard; Theoklis Zaoutis; John E Bennett Journal: Clin Infect Dis Date: 2008-06-15 Impact factor: 9.079
Authors: Prajwal Boddu; Pei-Ling Chen; Priyadharsini Nagarajan; Victor G Prieto; Alex Won; Mark Chambers; Steven Kornblau Journal: J Oral Maxillofac Surg Med Pathol Date: 2017-09-12
Authors: John A Ligon; Mukil Natarajan; Haneen Shalabi; Bonnie Yates; Rachel Bishop; David Bianchi; Alvaro Alencar; Michail S Lionakis; Nirali N Shah Journal: Pediatr Blood Cancer Date: 2019-03-22 Impact factor: 3.167