Filtration leukopheresis granulocyte support for infected neutropenic patients

A pilot study of granulocyte support for neutropenic infected patients by means of white cells collected from the Aminco Celltrifuge at the Peter MacCallum Clinic showed acceptable side effects in donor and recipients, and an encouraging recovery occurred in two out of four patients treated. White cell filtration leukopheresis was introduced at the Alfred Hospital Haematology and Medical Oncology Unit in November, 1975, for supportive therapy of all patients with white cell counts below 500/mm3 who had sustained febrile episodes (temperatures greater than 38 degrees C for more than 48 hours) while receiving appropriate or empiric parenteral antibiotic therapy. A minimum of four or more daily transfusions was given from group and cross-matched compatible donors until fever lysis, recovery of the neutrophil count to over 500/mm3 or death. Of 13 patients given white cell support, 12 survived and were discharged from hospital. One patient died having received only one transfusion when he was moribund. We believe that white cell filtration leukopheresis cell support is useful when used with parenteral antibiotic therapy for infected neutropenic patients, and it has resulted in a high rate of recovery from life-threatening infection in patients at risk.