Use of healthy-donor granulocyte transfusions to treat infections in neutropenic patients with myeloid or lymphoid neoplasms: experience in 74 patients treated with 373 granulocyte transfusions.

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Safdar A(1), Rodriguez G, Zuniga J, Al Akhrass F, Pande A.

Acta Haematol. 2014;131(1):50-8.

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.