Clinical outcome of granulocyte transfusion therapy for the treatment of refractory infection in neutropenic patients with hematological diseases
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Neutropenic patients with hematological diseases are prone to severe infections. Granulocyte transfusion therapy (GTX) is considered as a logical therapeutic approach for these problems. However, the efficacy and complications of GTX have not been well identified. We retrospectively analyzed the clinical outcomes of GTX therapy in our hospital from 2009 to 2015. After 117 granulocyte transfusions for 47 patients, 72.3% of these patients’ infections were effectively improved, and the overall survival rates at 30 and 120 days were 66.0 and 57.5%, respectively. The patients who experienced neutrophil recovery within 10 days after their therapy initiation had a better response and long-term survival period (14/15, 93.3%, vs 20/32, 62.5%, P = 0.037). Higher-dose granulocytes (> 2.55 × 108/kg) might improve the effective rate of infection in the patients who had more than 10 days neutrophil recovery time (17/23, 73.9%, vs 3/9, 33.3%, P = 0.049). In addition, GTX benefited the patients who suffered from pulmonary bacterial infections (16/20, 80%) compared with the bloodstream infection group (7/12, 58.3%) and skin or mucous infection group (1/5, 20%). The primary data showed that GTX did not affect the incidence of graft-versus-host disease (GVHD) and cytomegalovirus viremia when patients received further HSCT treatment. Collectively, GTX was an adjunct treatment modality for severely neutropenic patients who were likely to experience hematopoietic recovery. More randomized trials are needed to verify the efficacy and complications of GTX therapy.
KeywordsGranulocyte transfusion therapy Neutropenia Refractory infection Hematopoietic stem cell transplantation
This work was supported in part by grants from the Natural Science Foundation of Jiangsu Province (BK20171205), the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD), the National Natural Science Foundation of China (81302046, 81730003), Innovation Capability Development Project of Jiangsu Province (BM2015004), and the National Key R&D Program of China (2016YFC0902800, 2017YFA0104502).
Compliance with ethical standards
This study was conducted in compliance with the institutional policy regarding the protection of patients’ private information and approved by the Research Ethics Committee of the First Affiliated Hospital of Soochow University. All the methods were carried out in accordance with the approval guidelines of The First Affiliated Hospital of Soochow University.
Conflict of interest
The authors declare that they have no competing interests.
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