Blood Res.  2019 Mar;54(1):52-56. 10.5045/br.2019.54.1.52.

Analysis of hematologic parameters of donors, patients, and granulocyte concentrates to predict successful granulocyte transfusion

• Lee JM
• Choi SJ
• Kim HS
• Yang M
• Kim Y
• Lee JW
• Lim J

• KMID: 2451056
• DOI: http://doi.org/10.5045/br.2019.54.1.52

Abstract

BACKGROUND
Granulocyte transfusion (GTx) is performed as a supportive therapy in severe neutropenic patients caused by various conditions. The study aimed to analyze the hematologic parameters of donors, patients, and granulocyte concentrates to predict successful GTx.
METHODS
This study was performed in 281 donors, with their granulocyte concentrates being collected through apheresis, and in 54 severe neutropenic patients who had various hematologic diseases. Complete blood cell counts of donors pre- and post-apheresis, granulocyte concentrates, and patients pre- and post-GTx were analyzed. Patients were divided into two groups according to survival at discharge (Group S, survival; Group D, dead) to compare various factors including age, infection status, pre- and post-GTx total white blood cell counts (TWBCC) and absolute neutrophil counts (ANC), total number of GTx, infused TWBCC and ANC per weight, and use of G-CSF during therapy.
RESULTS
Overall data of patients showed that both TWBCC and ANC were significantly increased after GTx (median values at pre-GTx, TWBCC=0.40×109/L, ANC=0.14×109/L; post-GTx, TWBCC=0.57×109/L, ANC=0.29×109/L, both P<0.0001). After GTx, Group S (N=25) showed significantly higher TWBCC and ANC than Group D (N=29) (P=0.01 and P=0.04, respectively). Using different cutoff levels, post-GTx TWBCC greater than 0.5×109/L showed statistically significant difference between the two groups (P<0.01). None of the other factors showed statistically significant differences.
CONCLUSION
The TWBCC and ANC after GTx were significant factors to predict patients' outcome. Therefore, follow-up of those two parameters may be helpful to select or consider other therapeutic modalities including additional GTx.

Keyword

Granulocyte transfusion; Neutropenia; Total white blood cell counts; Absolute neutrophil counts; Granulocyte colony-stimulating factor

MeSH Terms

Blood Cell Count
Blood Component Removal
Follow-Up Studies
Granulocyte Colony-Stimulating Factor
Granulocytes*
Hematologic Diseases
Humans
Leukocyte Count
Neutropenia
Neutrophils
Tissue Donors*
Granulocyte Colony-Stimulating Factor

Reference

1. Elebute M, Massey E, Benjamin S, Stanworth S, Navarrete C, Lucas G. Clinical Guidelines for the Use of Granulocyte Transfusions. Bristol, UK: NHS Blood and Transplant;2012.

2. Strauss RG. Role of granulocyte/neutrophil transfusions for haematology/oncology patients in the modern era. Br J Haematol. 2012; 158:299–306.

3. Price TH, Boeckh M, Harrison RW, et al. Efficacy of transfusion with granulocytes from G-CSF/dexamethasone-treated donors in neutropenic patients with infection. Blood. 2015; 126:2153–2161.

4. Teofili L, Valentini CG, Di Blasi R, et al. Dose-dependent effect of granulocyte transfusions in hematological patients with febrile neutropenia. PLoS One. 2016; 11:e0159569.

5. Ministry of Health and Welfare. The administration law of blood management. Sejong, Korea: Ministry of Health and Welfare;2016.

6. Price TH. Granulocyte transfusion therapy: it's time for an answer. Transfusion. 2006; 46:1–5.

7. Lee SN, Hu Y, Eom HS, Lee H, Lee E, Kong SY. Analysis of granulocyte transfusions in patients with infections and neutropenia: a single center experience. Korean J Blood Transfus. 2016; 27:247–256.

8. Hester JP, Dignani MC, Anaissie EJ, Kantarjian HM, O'Brien S, Freireich EJ. Collection and transfusion of granulocyte concentrates from donors primed with granulocyte stimulating factor and response of myelosuppressed patients with established infection. J Clin Apher. 1995; 10:188–193.

9. Adkins D, Spitzer G, Johnston M, Velasquez W, Dunphy F, Petruska P. Transfusions of granulocyte-colony-stimulating factor-mobilized granulocyte components to allogeneic transplant recipients: analysis of kinetics and factors determining posttransfusion neutrophil and platelet counts. Transfusion. 1997; 37:737–748.

10. Price TH, Bowden RA, Boeckh M, et al. Phase I/II trial of neutrophil transfusions from donors stimulated with G-CSF and dexamethasone for treatment of patients with infections in hematopoietic stem cell transplantation. Blood. 2000; 95:3302–3309.

11. Rutella S, Pierelli L, Sica S, et al. Efficacy of granulocyte transfusions for neutropenia-related infections: retrospective analysis of predictive factors. Cytotherapy. 2003; 5:19–30.

12. Ofran Y, Avivi I, Oliven A, et al. Granulocyte transfusions for neutropenic patients with life-threatening infections: a single centre experience in 47 patients, who received 348 granulocyte transfusions. Vox Sang. 2007; 93:363–369.