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Image-based Flow Cytometry Technique to Evaluate Changes in Granulocyte Function In Vitro
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Published on: December 26, 2014

Revisiting the use of granulocyte transfusions in pediatric oncology patients

Alan S Graham1, Thomas H Price, Thomas V Brogan

  • 1Department of Pediatrics, Division of Pediatric Critical Care, Oregon Health and Science University, Portland, OR 97239-2901, USA. grahamal@ohsu.edu

Journal of Pediatric Hematology/Oncology
|March 6, 2009
PubMed

Insights

Granulocyte transfusions (GTF) in pediatric oncology patients with neutropenia showed good short-term survival, with 71% surviving hospitalization. However, long-term outcomes remain challenging for this vulnerable population.

Area of Science:

  • Pediatric Hematology-Oncology
  • Transfusion Medicine
  • Infectious Diseases

Background:

  • Neutropenia in pediatric oncology patients significantly increases infection risk.
  • Serious infections in neutropenic patients often require aggressive management.
  • Granulocyte transfusions (GTF) are a supportive therapy option for severe neutropenic infections.

Purpose of the Study:

  • To evaluate the clinical course and outcomes of pediatric oncology patients receiving granulocyte transfusions.
  • To assess the safety and efficacy of GTF in this high-risk population.

Main Methods:

  • Retrospective chart review of 13 pediatric oncology patients (9 months to 16 years) receiving GTF for neutropenic infections between March 1998 and June 2000.
  • Analysis of 14 GTF courses, noting number of transfusions, pre-transfusion infections, and patient outcomes.
  • Evaluation of short-term outcomes including survival to discharge and extubation status.

Main Results:

  • 71% (10/14) of GTF courses were followed by survival to hospital discharge.
  • All 5 intubated patients were extubated after GTF.
  • Despite short-term improvements, the overall mortality rate was 62% (8/13 patients), with two early deaths from invasive Aspergillus.

Conclusions:

  • Granulocyte transfusions were generally well-tolerated in this cohort of septic neutropenic pediatric oncology patients.
  • GTF demonstrated promising short-term survival benefits, including improved respiratory status.
  • Long-term survival remains a significant challenge, highlighting the critical nature of these infections.
Abstract

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