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Alloimmunization following prophylactic granulocyte transfusion.

C A Schiffer, J Aisner, P A Daly

    Blood
    |October 1, 1979
    PubMed
    Summary
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    Prophylactic granulocyte transfusions in acute nonlymphocytic leukemia (ANLL) patients increased transfusion reactions and alloimmunization. This suggests granulocyte transfusions should not be routine therapy.

    Area of Science:

    • Hematology
    • Oncology
    • Immunology

    Background:

    • Acute nonlymphocytic leukemia (ANLL) patients undergoing chemotherapy are at high risk for infection.
    • Prophylactic transfusions are sometimes used to prevent infections in these vulnerable patients.

    Purpose of the Study:

    • To evaluate the efficacy and safety of prophylactic granulocyte transfusions compared to platelet transfusions alone in noninfected ANLL patients receiving induction chemotherapy.

    Main Methods:

    • Nineteen noninfected ANLL adults were randomized to receive either prophylactic granulocyte transfusions or platelet transfusions alone.
    • Transfusions were administered on an alternate-day schedule.

    Main Results:

    • Granulocyte transfusion recipients experienced significantly more transfusion reactions (7/10 vs. 1/9) and developed lymphocytotoxic antibodies (7/10 vs. 4/9).

    Related Experiment Videos

  • Alloimmunization to granulocytes complicated platelet support, and one patient developed a pulmonary infiltrate.
  • No severe infections occurred in the granulocyte group, but three fungal infections occurred in the control group.

    • Conclusions:

    • High rates of alloimmunization and transfusion reactions suggest prophylactic granulocyte transfusions are not suitable for routine therapy in ANLL.
    • Further investigation in controlled, investigational settings is warranted for granulocyte transfusions.