Korean J Pediatr Hematol Oncol.  2002 Apr;9(1):64-71.

Granulocyte Transfusion in Severe Neutropenic Pediatric Patients

• Kang JH
• Yang HK
• Kim SN
• Kim MK

Abstract

PURPOSE: The use of granulocyte transfusion (GT) which had been diminished since 1980s has been recently interested on the base of clinical efficacy approved by transfusion of granulocyte collected after administration of granulocyte-colony stimulating factor (G-CSF) to donors. So we studied the clinical efficacy of GT in severe neutropenic pediatric patients with severe infections.
METHODS
Twelve patients with malignant hematologic disorders and solid tumors in Ajou University Hospital from March 1997 to February 2001 were indicated for GT. These patients had continuous neutropenia-related infections despite appropriate antibiotics, antifungal or IV immunoglobulin therapy. GTs were carried out 12 hrs after collection of granulocytes using leukapheresis from donors stimulated by G-CSF.
RESULTS
The median number of GT is 3 (2~7), and the mean dose of granulocyte is 3.51+/-4.21 10(10)/m(2) and mean volume of granulocyte is 220 +/-22.92 mL. The median duration of the use of G-CSF and antibiotics or antifungal agents is 6 (3~14) days and 3 (1~9) days. Ten of 12 patients had favorable responses (FR), and 2 patients had unfavorable responses (UR). Two patients who had FR died of acute respiratory distress syndrome (ARDS), complication of GT.
CONCLUSION
GT is effective treatment for severe neutropenic pediatric patients with severe infections. Enough amount of granulocytes could be collected after administration of G-CSF without dexamethasone to donors. However, ARDS which is an adverse effect of GT, is considered in pulmonary compromised patients.

Keyword

Granulocyte transfusion; Granulocyte-colony stimulating factor; Acute respiratory distress syndrome; Leukapheresis; Neutropenia

MeSH Terms

Anti-Bacterial Agents
Antifungal Agents
Dexamethasone
Granulocyte Colony-Stimulating Factor
Granulocytes*
Humans
Immunization, Passive
Leukapheresis
Neutropenia
Respiratory Distress Syndrome, Adult
Tissue Donors
Anti-Bacterial Agents
Antifungal Agents
Dexamethasone
Granulocyte Colony-Stimulating Factor