Granylocyte transfusion: a controlled study in patients with acuute nonlymphocytic leukemia

Granulocyte transfusions are frequently used during the leukopenic phase of induction chemotherapy for acute nonlymphocytic leukemia (ANLL) although no controlled study has documented their usefulness. We have compared the morbidity and mortality of febrile episodes in granulocytopenic (less than 500/mm3) adults with ANLL who received granulocytes and those who did not. Granulocytes were obtained from related normal donors using a continuous flow centrifuge. Seventeen patients who received 98 transfusions during 23 febrile episodes were compared with 22 patients who received no granulocytes during 35 febrile episodes. No significant difference in clearing of documented infection occurred between the transfused (71%) or the control (76%) group. Granulocytes did not result in more rapid termination of febrile episodes nor in significant decrease in fever 24 hours following the transfusion. Factors contributing to the lack of obvious clincal benefit are discussed.