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Therapy

Treatment of neutropenia-related fungal infections with granulocyte colony-stimulating factor-elicited white blood cell transfusions: a pilot study

Abstract

Neutropenia-related fungal infections can be life-threatening despite antifungal therapy. We evaluated the role of recombinant granulocyte colony-stimulating factor (rG-CSF)-elicited white blood cell (WBC) transfusions in patients with neutropenia-related fungal infections. Adult patients with hematologic malignancies, absolute neutrophil counts (ANC) <500/μl and fungal infections refractory to amphotericin b, received daily transfusions of rg-csf-elicited and irradiated wbc transfusions from related donors. donors received 5 μg/kg/day of rg-csf subcutaneously. donors achieved a mean anc of 29.4 × 103 per microliter. The mean yield of neutrophils per transfusion was 41 × 109 (range, 10–116). Fifteen patients received a median of eight transfusions (range, 3–16). Fourteen patients had received rG-CSF for a median of 12 days. The median ANC baseline was 20/μl. Eleven patients had favorable responses and eight of them remained free of infection 3 weeks after therapy. Favorable responses occurred among patients with better Zubrod performance status (median, 3 vs 4) and shorter duration of both profound neutropenia (median, 15 vs 25 days) and active infection (median, 8 vs 17 days). The mean 1- and 24-h post-transfusion ANCs were 594/μl (range, 98–1472/μl) and 396/μl (range, 50–1475/μl), respectively. Adverse reactions were observed in nine of 35 donors and in the recipients of six of 130 transfusions. rG-CSF-elicited WBC transfusions may be a safe and promising approach for treating neutropenia-related fungal infections.

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Dignani, M., Anaissie, E., Hester, J. et al. Treatment of neutropenia-related fungal infections with granulocyte colony-stimulating factor-elicited white blood cell transfusions: a pilot study. Leukemia 11, 1621–1630 (1997). https://doi.org/10.1038/sj.leu.2400811

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  • DOI: https://doi.org/10.1038/sj.leu.2400811

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