Navigating the neutropenic abyss with granulocyte transfusions: Retrospective single-center analysis of effectiveness and safety in India

IF 1.4 4区医学 Q4 HEMATOLOGY

Journal of Clinical Apheresis Pub Date : 2023-08-10 DOI:10.1002/jca.22084

Priti Desai MD, DCP, Anisha Navkudkar MD, DNB, Bhausaheb Bagal MD, DM, Chetan Dhamne MD, Hasmukh Jain MD, DM, Manju Sengar MD, DM, Girish Chinnaswamy MD, DM, Lingaraj Nayak MD, DM

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引用次数: 0

Abstract

Background

Hemato-oncologic patients receiving intensive chemotherapy may develop severe neutropenia and serious bacterial and/or fungal infections. Granulocyte transfusions (GTs) may be beneficial as a bridging therapy in hemato-oncologic patients with febrile neutropenia.

Aim

To evaluate the clinical effectiveness of GTs in hemato-oncologic patients with febrile neutropenia.

Materials and Methods

This retrospective study evaluated the effectiveness of 150 GTs in 88 hemato-oncologic patients. Donors were mobilized with granulocyte colony-stimulating factors and dexamethasone. Patients' hematological parameters (pre- and post-GT) and safety and effectiveness of GTs were analyzed.

Results

The safety and effectiveness of GTs were assessed in the patients with various underlying conditions, including 78% with acute myeloid leukemia. In total, 150 GTs were administered, mostly during the chemotherapy induction phase. The GTs were well-tolerated by the patients, and a significant increment in white blood cell count and absolute neutrophil count (ANC) was noticed in 95% of patients after the transfusion. The granulocyte dose was positively correlated with ANC after the transfusion. The average time to neutrophil recovery from the last day of GT was 6.7 days, and the 30-day survival rate was 77%. The donors were all men, and a significant increase in WBC count was observed post-mobilization. The median granulocyte yield was 2.28 × 10¹⁰/unit. All granulocyte products were crossmatched and irradiated before the transfusion.

Conclusion

GTs can be a useful adjunctive treatment for febrile neutropenia in hemato-oncologic patients with multidrug-resistant sepsis. However, additional studies are required for confirming their effectiveness and establishing guidelines for their use.

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用粒细胞输注来应对中性粒细胞减少的深渊：印度单中心有效性和安全性回顾性分析

背景:接受强化化疗的血液肿瘤患者可能出现严重的中性粒细胞减少症和严重的细菌和/或真菌感染。粒细胞输注(GTs)可能是有益的桥接治疗血液肿瘤患者发热性中性粒细胞减少。目的评价GTs治疗血液肿瘤发热性中性粒细胞减少症的临床疗效。材料与方法本回顾性研究评估了88例血液肿瘤患者150例GTs的疗效。用粒细胞集落刺激因子和地塞米松动员供体。分析患者血液学参数(gt前后)及gt的安全性和有效性。结果评估了GTs在各种基础疾病患者中的安全性和有效性，其中78%为急性髓性白血病。总共给药150次，大部分在化疗诱导期。患者对GTs耐受良好，95%的患者输血后白细胞计数和绝对中性粒细胞计数(ANC)显著增加。输血后粒细胞剂量与ANC呈正相关。从GT最后一天到中性粒细胞恢复的平均时间为6.7 d, 30天存活率为77%。献血者均为男性，动员后观察到白细胞计数显著增加。中位粒细胞产率为2.28 × 1010/单位。所有的粒细胞产物在输血前进行交叉匹配和辐照。结论GTs可作为多药耐药脓毒症血液肿瘤患者发热性中性粒细胞减少症的有效辅助治疗。但是，还需要进一步的研究来证实它们的有效性并为它们的使用制定指导方针。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Apheresis 医学-血液学

CiteScore

2.80

自引率

13.30%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Clinical Apheresis publishes articles dealing with all aspects of hemapheresis. Articles welcomed for review include those reporting basic research and clinical applications of therapeutic plasma exchange, therapeutic cytapheresis, therapeutic absorption, blood component collection and transfusion, donor recruitment and safety, administration of hemapheresis centers, and innovative applications of hemapheresis technology. Experimental studies, clinical trials, case reports, and concise reviews will be welcomed.