Granulocyte transfusion therapy

Transfusions of granulocytes have been used for many decades to treat serious infections in patients with sustained periods of granulocytopenia. The benefit has been limited somewhat by the technical problems of obtaining adequate doses of granulocytes from normal donors and by histocompatibility issues in alloimmunized recipients. The introduction of granulocyte colony-stimulating factor (G-CSF) as a means to induce granulocytosis in donors has rekindled interest in this therapy, particularly for the treatment of invasive fungal infections. Granulocyte yields after G-CSF stimulation are routinely 3 to 4 times higher than have been used in the past and have resulted in posttransfusion increments for more than 24 hours after transfusion. Studies in progress should help define the utility of these higher dose transfusions in patients with infections refractory to antibiotic therapy.