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- Title
Therapeutic transfusions of granulocytes collected by simple bag method for children with cancer and neutropenic infections: results of a single-centre pilot study.
- Authors
Kikuta, A.; Ohto, H.; Nemoto, K.; Mochizuki, K.; Sano, H.; Ito, M.; Suzuki, H.
- Abstract
Background and Objectives Granulocyte transfusion therapy (GTX) can be effective for life-threatening infections unresponsive to conventional antimicrobial therapies in severely neutropenic children with cancer. We developed a new granulocyte collection method, named the ‘bag method’, in which apheresis, hydroxyethyl starch (HES) or dexamethasone are not used. We undertook a pilot study to determine the feasibility and the safety of GTX collected by the bag method for children with cancer and life-threatening infections. Materials and Methods A total of 25 GTX were administered to 13 patients (median age 3 years, range: 0·3–17; median weight 10·6 kg, range: 4·5–49·8) with neutropenia-related infections. Thirteen blood-relative donors received granulocyte colony-stimulating factor (G-CSF) (5–10 µg/kg), subcutaneously, 14 h before collection. Major end-points were granulocyte yields, post-transfusion absolute neutrophil counts (ANC) in patients, donor and patient safety, and clinical outcome on day 30. Results The median yield of ANC per 400 ml of processed whole blood was 6·2 × 109 (range: 2·5–15·0 × 109). Patients received a mean of 6·4 ± 0·8 × 108 granulocytes per kg of body weight per transfusion. The 1-h and 24-h post-transfusion ANC rose to 607 ± 124/µl and 704 ± 300/µl, respectively, from the baseline of 21/µl before the first GTX. Adverse reactions were observed in five of 13 donors (bone pain, headache, vasovagal reaction; all ≤ grade 2) and in two of 25 transfusions of 13 patients (transient hypoxia; grade 3). Ten patients had favourable responses, and infection resolved in nine patients. Conclusions The bag method without apheresis relieves the physical load of donors and enables patients with a low body weight to provide an adequate dose of granulocytes.
- Subjects
PEDIATRIC therapy; CANCER; BLOOD transfusion; THERAPEUTICS; GRANULOCYTES; JUVENILE diseases
- Publication
Vox Sanguinis, 2006, Vol 91, Issue 1, p70
- ISSN
0042-9007
- Publication type
Article
- DOI
10.1111/j.1423-0410.2006.00776.x