Granulocyte transfusion combined with granulocyte colony stimulating factor in severe infection patients with severe aplastic anemia: a single center experience from China.

Abstract

OBJECTIVE:

To investigate the efficacy and safety of granulocyte transfusion combined with granulocyte colony stimulating factor (G-CSF) in severe infection patients with severe aplastic anemia (SAA).

METHODS:

Fifty-six patients in severe infections with SAA who had received granulocyte transfusions combined with G-CSF from 2006 to 2012 in our department were analyzed. A retrospective analysis was undertaken to investigate the survival rates (at 30 days, 90 days and 180 days), the responses to treatment (at 7 days and 30 days, including microbiological, radiographic and clinical responses), the neutrophil count and adverse events after transfusion.

RESULTS:

All SAA patients with severe infections were treated with granulocyte transfusions combined with G-CSF. Forty-seven patients had received antithymocyte globulin/antilymphocyte globulin and cyclosporine A as immunosuppressive therapy. The median number of granulocyte components transfused was 18 (range, 3-75). The survival at 30 days, 90 days and 180 days were 50(89%), 39(70%) and 37(66%) respectively. Among 31 patients who had invasive fungal infections, the survival at 30 days, 90 days and 180 days were 27(87%), 18(58%) and 16(52%) respectively. Among the 25 patients who had refractory severe bacterial infections, the survival at 30 days, 90 days and 180 days were 23(92%), 21(84%) and 21(84%) respectively. Survival rate was correlated with hematopoietic recovery. Responses of patients at 7 and 30 days were correlated with survival rate. Common adverse effects of granulocyte transfusion included mild to moderate fever, chills, allergy and dyspnea.

CONCLUSION:

Granulocyte transfusions combined with G-CSF could be an adjunctive therapy for treating severe infections of patients with SAA.

• Authors: Huaquan Wang, Yuhong Wu, Rong Fu, Wen Qu, Erbao Ruan, Guojin Wang, Hong Liu, Jia Song, Limin Xing, Jing Guan, Lijuan Li, Chunyan Liu, Zonghong Shao
• Journal: PloS one (PLoS One) Vol. 9 Issue 2 Pg. e88148 ( 2014) ISSN: 1932-6203 [Electronic] United States
• PMID: 24505406 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antilymphocyte Serum
• Immunosuppressive Agents
• Granulocyte Colony-Stimulating Factor
• Cyclosporine

Topics

• Adolescent
• Adult
• Aged
• Anemia, Aplastic (complications)
• Antilymphocyte Serum (therapeutic use)
• Bacterial Infections (complications, therapy)
• Child
• Cyclosporine (therapeutic use)
• Female
• Granulocyte Colony-Stimulating Factor (therapeutic use)
• Granulocytes (cytology, metabolism)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Leukocyte Transfusion (methods)
• Male
• Middle Aged
• Mycoses (complications, therapy)
• Retrospective Studies
• Survival Rate
• Young Adult