Therapeutic role of granulocyte transfusions

Granulocyte transfusions are used as adjuvant therapy for infection in neutropenic patients with underlying neoplastic disease, neutropenic infants, and patients with qualitative white blood cell disorders. In addition, prophylactic leukocyte transfusions have been administered to patients during remission induction for acute leukemia or after bone marrow transplantation. The role of granulocyte therapy will need constant reassessment as new antibiotics and other forms of treatment are developed. At present, granulocyte transfusions are indicated in the treatment of severely neutropenic patients with documented bacterial infection who are unlikely to recover hematopoietic function over the next week and are deteriorating despite 48-72 hr of optimal antibiotic therapy. Under these conditions, they improve the rate of survival from the infectious episode without clearly affecting the longer-term survival of the patient. Only a small minority of neutropenic patients will require granulocyte transfusions.