Granulocyte transfusions from G-CSF- and dexamethasone-stimulated healthy donors for treatment of patients with severe neutropenia-related infections
Year: 2003
Type: article
Study design: Clinical Trial
Abstract: Background : Granulocyte transfusions have been used to treat severe, progressive infections in neutropenic patients who fail to respond to antimicrobial agents. Although corticosteroid or granulocyte colony-stimulating factor (G-CSF) were previously used separately to increase leukocyte counts in healthy donors, increasingly G-CSF and corticosteroids are used together, requiring the need to establish the efficacy of this mobilizing regime. Methods : This prospective study evaluated the safety and efficacy of granulocyte transfusion therapy from donors stimulated with a combination of G-CSF and dexamethasone, in 27 patients with severe neutropenia-related infections. To mobilize granulocytes, healthy volunteer donors received G-CSF, 5 g/kg subcutaneously 12-14 hr before leukapheresis, and dexamethasone, 3 mg/ intravenously 15 min before leukapheresis. Results: Donor neutrophil counts were 5,723/L (range: 1,500-36,420) at baseline, 22,104/L (range: 9,700-41,300) before the injection of dexamethasone, 23,946/L (range: 10,900-42,100) immediately before leukapheresis, and 19,913/L (range: 9,100-36,300) after leukapheresis. Ninety-two leukapheresis procedures were performed with a mean yield of 7.88 granulocytes (range: 2.2-17.9. The mobilizing agents were well tolerated in the donors. Of the patients, 16(59.3%) showed favorable responses, whereas 11 (40.7%) had unfavorable responses. Adverse reactions to the therapy were arrhythmia in two patients (7.4%) and pulmonary edema in one patient (3.7%). Favorable responses were seen in 83.3, 76.9, and 45.5% of the patients from whom fungal, Gram-negative, and Gram-positive organisms were isolated, respectively. Conclusion : This study suggests that the combination of G-CSF and dexamethasone is an effective, well-tolerated regimen for mobilizing granulocytes from healthy donors, and that granulocyte transfusion therapy is useful for neutropenic patients, especially those with fungal or Gram-negative infections that are resistant to appropriate antimicrobial agents.
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $500
OpenAlex ID: W2349444282