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Granulocyte transfusion in treatment of infected neutropenic children
Insights
Granulocyte transfusions helped children with severe neutropenia, often caused by leukemia or aplastic anemia, fight infections. This treatment significantly reduced deaths and illness in these vulnerable pediatric patients.
Area of Science:
- Pediatric Hematology
- Infectious Diseases
- Transfusion Medicine
Background:
- Severely neutropenic children with acute leukemia and aplastic anemia often face life-threatening infections resistant to antibiotics.
- Granulocyte transfusions are a potential therapeutic option for these patients.
Purpose of the Study:
- To evaluate the efficacy of granulocyte transfusions in treating infections in severely neutropenic children.
- To assess factors influencing response and outcomes.
Main Methods:
- Fifty-one granulocyte transfusions were administered to 30 children with severe neutropenia undergoing treatment for acute leukemia or aplastic anemia.
- Granulocyte counts were monitored post-transfusion, and clinical responses were assessed over 5 days.
Main Results:
- A mean granulocyte increment of 820/mm3 at 1 hour and 307/mm3 at 15 hours post-transfusion was observed.
- Clinical response was seen in 50% of episodes within 24 hours and 77% within 5 days.
- Factors like infection site and duration prior to transfusion impacted response; primary diagnosis did not.
Conclusions:
- Granulocyte transfusions significantly improved clinical outcomes in neutropenic children with acute leukemia.
- The study demonstrates a reduction in mortality and morbidity associated with these infections through transfusion therapy.
Abstract:
Thirty episodes of infection in severely neutropenic children with acute leukaemia and aplastic anaemia resistant to antibiotics were treated with total of 51 granulocyte transfusions collected from normal donors by means of an Aminco continuous flow cell separator. The mean granulocyte increment in the recipients was 820/mm3 at 1 hour and 307/mm3 at 15 hours post-transfusion and it showed a correlation with the number of cells transfused, the size of the child, and his pretransfusion granulocyte count. Fifteen (50%) episodes responded clinically by 24 hours and 23 (77%) by 5 days post-transfusion. Two more children recovered more slowly and 5 died. Poor response was associated with multiple-site infections and with a prolonged period of infection before granulocyte transfusion, but the primary diagnosis did not influence the outcome. We conclude that granulocyte transfusion significantly reduces the mortality and morbidity from infection in neutropenic children with acute leukaemia.