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Prophylactic and interventional granulocyte transfusions in patients with haematological malignancies and life-threatening infections during neutropenia

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Abstract

Patients with haematological malignancies and prolonged periods of neutropenia after chemotherapy are at high risk for severe bacterial and fungal infections. Those infections have long time been considered as a contraindication for subsequent haematopoietic stem cell transplantation (HCT). We conducted a prospective, non-randomized study of granulocyte transfusions (GTX) to control acute life-threatening infections (44 episodes) and to prevent recurrence of severe fungal infections during HCT or intensive chemotherapy (23 episodes). GTX achieved control in 82% (36/44) of acute life-threatening infections. No single reactivation of a previous infection occurred under prophylactic GTX (0/23). Median survival was 170 days in the interventional group and 185 days in the prophylactic group; death in both patient groups was mainly due to underlying progressive malignant disease. We conclude that under GTX, the infection-related mortality even in high-risk patients is low. Due to a secondary prophylaxis with GTX, haematopoietic allografts can be safely given to patients with previous fungal infections.

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Acknowledgements

This work was supported by Knochenmarktransplantation/Gentherapie Frankfurt (KGF) e.V. The authors thank the haematology nursing staff for their excellent patient care.

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Authors and Affiliations

  1. Department of Haematology and Oncology, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany

    Sabine Mousset, Stella Hermann, Stefan A. Klein, Barbara Wassmann, Angelika Böhme, Dieter Hoelzer & Hans Martin

  2. Institute of Transfusion Medicine, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany

    Heike Bialleck, Michaele Duchscherer & Barbara Bomke

  3. Medizinische Klinik II, Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany

    Sabine Mousset

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  1. Sabine Mousset
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  2. Stella Hermann
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  3. Stefan A. Klein
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  9. Dieter Hoelzer
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  10. Hans Martin
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Correspondence to Sabine Mousset.

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Mousset, S., Hermann, S., Klein, S.A. et al. Prophylactic and interventional granulocyte transfusions in patients with haematological malignancies and life-threatening infections during neutropenia. Ann Hematol 84, 734–741 (2005). https://doi.org/10.1007/s00277-005-1055-z

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  • DOI: https://doi.org/10.1007/s00277-005-1055-z

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