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Does granulocyte transfusion help pediatric cancer patients with sepsis?
Swaminathan Keerthivasagam1, Shyam Srinivasan1, Anisha Navkudkar2
1Division of Pediatric oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
Insights
Granulocyte transfusions helped clear infections in pediatric cancer patients with severe sepsis, including those caused by multidrug-resistant organisms (MDROs). This approach offers a potential strategy to combat sepsis mortality in this vulnerable population.
Area of Science:
- Pediatric Oncology
- Infectious Diseases
- Hematology
Background:
- Sepsis poses a significant mortality risk in pediatric cancer patients, exacerbated by multidrug-resistant organisms (MDROs).
- Intensive chemotherapy regimens increase susceptibility to severe infections in children with hematolymphoid malignancies.
Purpose of the Study:
- To evaluate the efficacy of granulocyte transfusion as an adjunct to standard antimicrobial therapy for severe sepsis in pediatric cancer patients.
- To assess the impact of granulocyte transfusion on organism clearance and mortality in cases involving MDROs.
Main Methods:
- Retrospective study at an Indian tertiary cancer center (January 2021 - December 2022).
- Included 64 children with hematolymphoid malignancy experiencing 75 episodes of severe sepsis post-chemotherapy.
- Granulocyte transfusion was administered alongside standard antimicrobial treatment.
Main Results:
- 83% of blood culture-proven sepsis cases were caused by MDROs.
- Organism clearance was observed in 70% of patients with blood culture-proven sepsis following granulocyte transfusion.
- Overall 30-day mortality was 25%, with 32% mortality in patients with MDRO sepsis.
Conclusions:
- Granulocyte transfusion may be an effective adjunctive therapy for severe sepsis in pediatric cancer patients, particularly those with MDRO infections.
- This intervention shows promise in improving outcomes and reducing mortality in a high-risk patient group.
Abstract:
Sepsis-related mortality continues to be a major concern while treating pediatric cancer patients, more so with the rise in the incidence of multidrug-resistant organisms (MDRO). In this retrospective study conducted between January 2021 and December 2022 at a tertiary cancer center in India, granulocyte transfusion was offered in addition to standard antimicrobial therapy to 64 children with hematolymphoid malignancy who developed 75 episodes of severe sepsis following intensive chemotherapy. Forty-four (83%) of 53 blood culture proven sepsis was caused by MDROs. Thirty-seven (70%) patients with blood culture proven sepsis cleared the organism after granulocyte transfusion. Thirty-day mortality was 25% for the entire study cohort and 32% for patients with MDRO sepsis.
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