Granulocyte transfusion therapy

V. Thrash, M. J. Stone, E. P. Frenkel

Research output: Contribution to journalArticle

Abstract

Granulocyte transfusion therapy constitutes a major advance in the management of bacterial and perhaps fungal infections associated with cancer therapy and marrow failure states. Both continuous flow centrifugation and filtration leukapheresis are effective methods of granulocyte procurement. The former technique is more advantageous in a basic research center since all blood components may be collected, justifying the expense and requirement for highly trained personnel. When only occasional support of neutropenic patients is needed, filtration leukapheresis is less expensive and required less training for its operation. Only patients with absolute neutrophil counts of less than 1.000/cu mm should be considered for transfusions. Precise indications for starting transfusions remain to be determined. Ideally transfusions should be reserved for documented or highly suspect bacterial or fungal infections. It would seem reasonable to begin transfusions in such cases in combination with continued appropriate antibiotics only after the patient has failed to respond to antibiotics for 48 hours. Transfusions should be administered for no less than four consecutive days. In cases of proven bacterial or fungal infection, transfusions should continue until granulocytopoiesis is restored or the infection is resolved. If transfusions are begun empirically in the febrile neutropenic patient they should be discontinued after four days if bacterial or fungal causes remain unproven or there is no clinical response to the transfusions. Donor and recipient should be ABO and Rh compatible. If marrow transplantation is likely, relatives should not be used as granulocyte donors. Although Graw's work demonstrates vividly that posttransfusion granulocyte recovery is markedly affected by HL-A compatability and the absence of leukocyte antibodies, clinical response does not appear to depend on these parameters. The effects of preformed antibody against donor cells require additional study. Side effects in the granulocyte donor should be negligible. Severe complications in the recipient are uncommon and consist predominantly of high fever and chills. Such toxic effects appear to be more frequent with granulocytes collected by the filtration method and may be minimized by slow infusion and proper premedication.

Original languageEnglish (US)
Pages (from-to)339-343
Number of pages5
JournalSouthern Medical Journal
Volume70
Issue number3
StatePublished - 1977

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Granulocytes
Mycoses
Tissue Donors
Leukapheresis
Bacterial Infections
Fever
Therapeutics
Bone Marrow
Anti-Bacterial Agents
Chills
Second Primary Neoplasms
Premedication
Poisons
Centrifugation
Antibody Formation
Neutrophils
Leukocytes
Transplantation
Antibodies
Infection

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Thrash, V., Stone, M. J., & Frenkel, E. P. (1977). Granulocyte transfusion therapy. Southern Medical Journal, 70(3), 339-343.

Granulocyte transfusion therapy. / Thrash, V.; Stone, M. J.; Frenkel, E. P.

In: Southern Medical Journal, Vol. 70, No. 3, 1977, p. 339-343.

Research output: Contribution to journalArticle

Thrash, V, Stone, MJ & Frenkel, EP 1977, 'Granulocyte transfusion therapy', Southern Medical Journal, vol. 70, no. 3, pp. 339-343.
Thrash, V. ; Stone, M. J. ; Frenkel, E. P. / Granulocyte transfusion therapy. In: Southern Medical Journal. 1977 ; Vol. 70, No. 3. pp. 339-343.
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