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Clinical outcome of granulocyte transfusion therapy for the treatment of refractory infection in neutropenic patients with hematological diseases

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Abstract

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.

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Funding

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).

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Author notes

  1. Biqi Zhou, Tiemei Song and Yufeng Feng contributed equally to this work.

Authors and Affiliations

  1. Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, the First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou, 215006, Jiangsu Province, People’s Republic of China

    Biqi Zhou, Tiemei Song, Yufeng Feng, Ziling Zhu, Weirong Chang, Yuejun Liu, Aining Sun, Depei Wu & Yang Xu

  2. Institute of Blood and Marrow Transplantation, Soochow University, Suzhou, People’s Republic of China

    Biqi Zhou, Aining Sun, Depei Wu & Yang Xu

  3. Collaborative Innovation Center of Hematology, Soochow University, Suzhou, People’s Republic of China

    Yuejun Liu, Aining Sun, Depei Wu & Yang Xu

Authors
  1. Biqi Zhou
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  2. Tiemei Song
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  3. Yufeng Feng
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  4. Ziling Zhu
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  7. Aining Sun
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  8. Depei Wu
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  9. Yang Xu
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Corresponding authors

Correspondence to Depei Wu or Yang Xu.

Ethics declarations

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.

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The authors declare that they have no competing interests.

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Zhou, B., Song, T., Feng, Y. et al. Clinical outcome of granulocyte transfusion therapy for the treatment of refractory infection in neutropenic patients with hematological diseases. Ann Hematol 97, 2061–2070 (2018). https://doi.org/10.1007/s00277-018-3432-4

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  • DOI: https://doi.org/10.1007/s00277-018-3432-4

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