{"title":"Should granulocyte transfusion therapy for septic neutropenic neonates be resurrected?","authors":"Shelley M Lawrence","doi":"10.1016/j.siny.2025.101616","DOIUrl":null,"url":null,"abstract":"<p><p>Nearly half a century ago, granulocyte transfusions were trialed in critically ill, septic, neutropenic neonates and showed improved survival when used concurrently with antimicrobials. Benefits were particularly noteworthy for Gram-negative and fungal infections. The introduction of granulocyte colony-stimulating factor into clinical medicine in 1991 and inherent problems associated with granulocyte procurement for transfusion caused granulocyte transfusions to become nearly extinct for this patient population. Simultaneous technological and clinical management advancements have enabled the survival of younger neonates, who are at the highest risk for neutropenia and neonatal sepsis. These infants have well-documented developmental deficiencies in the number and functional capabilities of their neutrophils compared to older patients. A continued surge in antimicrobial resistance and an increasing number of Gram-negative infections have created an urgent need for clinicians to rethink old therapies and consider new ones. This review details the evolution of granulocyte transfusions and whether they should be resurrected in neonatal patients.</p>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":" ","pages":"101616"},"PeriodicalIF":2.9000,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in Fetal & Neonatal Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.siny.2025.101616","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
Abstract
Nearly half a century ago, granulocyte transfusions were trialed in critically ill, septic, neutropenic neonates and showed improved survival when used concurrently with antimicrobials. Benefits were particularly noteworthy for Gram-negative and fungal infections. The introduction of granulocyte colony-stimulating factor into clinical medicine in 1991 and inherent problems associated with granulocyte procurement for transfusion caused granulocyte transfusions to become nearly extinct for this patient population. Simultaneous technological and clinical management advancements have enabled the survival of younger neonates, who are at the highest risk for neutropenia and neonatal sepsis. These infants have well-documented developmental deficiencies in the number and functional capabilities of their neutrophils compared to older patients. A continued surge in antimicrobial resistance and an increasing number of Gram-negative infections have created an urgent need for clinicians to rethink old therapies and consider new ones. This review details the evolution of granulocyte transfusions and whether they should be resurrected in neonatal patients.
期刊介绍:
Seminars in Fetal & Neonatal Medicine (formerly Seminars in Neonatology) is a bi-monthly journal which publishes topic-based issues, including current ''Hot Topics'' on the latest advances in fetal and neonatal medicine. The Journal is of interest to obstetricians and maternal-fetal medicine specialists.
The Journal commissions review-based content covering current clinical opinion on the care and treatment of the pregnant patient and the neonate and draws on the necessary specialist knowledge, including that of the pediatric pulmonologist, the pediatric infectious disease specialist, the surgeon, as well as the general pediatrician and obstetrician.
Each topic-based issue is edited by an authority in their field and contains 8-10 articles.
Seminars in Fetal & Neonatal Medicine provides:
• Coverage of major developments in neonatal care;
• Value to practising neonatologists, consultant and trainee pediatricians, obstetricians, midwives and fetal medicine specialists wishing to extend their knowledge in this field;
• Up-to-date information in an attractive and relevant format.