The white cells: use of granulocyte transfusions

Since serious infections are major complications in patients with fewer than 200 phagocytic cells per microliter or in patients with dysfunctional phagocytes, granulocyte transfusions have been used in an attempt to improve clinical outcome. After two decades of trial and clinical use, the role of granulocyte transfusions for therapy of serious infections has not been clearly established. The methods of harvest, storage, and transfusion of granulocytes are acceptable; however, the quantities that are obtained from donors restrict numbers of cells that may be transfused. Limited clinical response has diminished enthusiasm for the use of granulocyte transfusions as therapy, and their use as prophylaxis has been ineffective. Reported clinical data suggest that patients with persisting granulocytopenia with sepsis due to gram-negative bacteria and patients with chronic granulomatous disease with life-threatening infections unresponsive to aggressive antimicrobial therapy may benefit from granulocyte transfusions.