Reconsidering Granulocyte Infusions in Prolonged Neutropenia: A Case Report

A 39-year-old man with therapy-related acute myeloid leukemia (t-AML) had refractory disease after induction with 7+3 (cytarabine for seven days and daunorubicin for three days). Reinduction with FLAG-Ida (fludarabine, cytarabine, G-CSF, and idarubicin) resulted in a hypocellular bone marrow (<5%) and prolonged pancytopenia complicated by mucormycosis. He received granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) without improvement, leading to the decision to implement granulocyte infusions. There was temporary and mild improvement in the neutrophil count with resolution of mucormycosis. Ultimately, the patient succumbed to refractory AML. This case highlights the potential use of granulocyte infusions for prolonged neutropenia with infectious complications, while addressing the logistical difficulties and transient benefit of the intervention.