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Granulocyte transfusion therapy: update on potential clinical applications
1Department of Medicine, University of Washington, Seattle, Washington 98195-7185, USA.
Current Opinion in Hematology
|April 17, 2001
Summary
Granulocyte transfusions for severe infections are debated, but advances in donor stimulation and apheresis techniques are improving their effectiveness. Unrelated donors and improved storage offer new possibilities for this critical therapy.
Area of Science:
- Hematology
- Infectious Diseases
- Transfusion Medicine
Background:
- The clinical efficacy of granulocyte transfusions for severe bacterial and fungal infections is not well-established.
- Historically, limited donor stimulation and apheresis methods have restricted clinical benefit.
- Neutrophils are critical immune cells for fighting infections.
Purpose of the Study:
- To review the current applications of granulocyte transfusion therapy in managing infectious diseases.
- To highlight recent advancements that may enhance the effectiveness and accessibility of granulocyte transfusions.
- To address the ongoing controversy surrounding the clinical utility of this treatment modality.
Main Methods:
- Review of recent clinical studies and methodological advancements in granulocyte collection and storage.
- Analysis of neutrophil mobilization techniques in healthy donors, including the use of G-CSF.
- Evaluation of data on the use of unrelated community donors versus related family donors.
- Assessment of neutrophil function after storage of granulocyte concentrates.
Main Results:
- Granulocyte-colony stimulating factor (G-CSF) has significantly improved neutrophil yields from leukapheresis.
- Unrelated community donors are emerging as a safe and viable alternative to related family donors.
- Granulocyte concentrates show potential for storage for 24-48 hours while maintaining adequate neutrophil function.
- Recent advances are addressing previous limitations in granulocyte transfusion therapy.
Conclusions:
- Granulocyte transfusion therapy remains a potentially valuable, though controversial, option for life-threatening infections.
- Methodological improvements, including enhanced donor stimulation and apheresis, are increasing the feasibility and efficacy of granulocyte collection.
- The use of unrelated donors and extended storage capabilities may broaden the application of granulocyte transfusions in clinical practice.
- Further research is warranted to solidify the role of granulocyte transfusions in evidence-based infectious disease management.