Granulocyte Transfusion Therapy in Neutropenic Patients
Summary
Granulocyte transfusion therapy represents an adjunctive strategy to combat life-threatening infections in patients with profound neutropenia, most often arising during intensive chemotherapy or following haematopoietic stem cell transplantation. By supplying functional donor neutrophils, this intervention aims to bridge the period of marrow aplasia until endogenous neutrophil production resumes. Contemporary practice involves donor mobilisation with granulocyte colony-stimulating factor (G-CSF) and corticosteroids to yield cell concentrates rich in mature granulocytes, which are then transfused rapidly due to their limited ex vivo viability. Clinical outcomes hinge on timely administration, optimal cell dose and careful patient selection; early transfusion in febrile neutropenia has been correlated with improved resolution of refractory bacterial and fungal infections. However, heterogeneity in study design and the absence of robust randomised trials leave open questions regarding dose-response relationships, immunomodulatory effects and long-term safety. Reported adverse events include mild febrile reactions, alloimmunisation and, rarely, transfusion-related acute lung injury. The global significance of granulocyte transfusions is underscored in regions with high rates of multidrug-resistant infection and limited access to advanced antimicrobials, where this therapy may offer a vital lifeline.
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Granulocyte Transfusion Therapy in Neutropenic Patients publication trend
The graph below shows the total number of articles in granulocyte transfusion therapy in neutropenic patients across all publications each year (not limited to Nature Index journals).
Technical terms
Neutropenia: A haematological condition defined by an absolute neutrophil count below 0.5 × 109/L, predisposing patients to serious infection.
Granulocyte transfusion: The intravenous administration of donor-derived mature neutrophils to provide temporary innate immune support in neutropenic individuals.
Absolute neutrophil count (ANC): The calculated concentration of neutrophils in peripheral blood, used to quantify degree of neutropenia and guide transfusion decisions.
Granulocyte colony-stimulating factor (G-CSF): A cytokine employed to mobilise neutrophils into the peripheral circulation of healthy donors prior to apheresis collection.
Transfusion-related acute lung injury (TRALI): A rare but serious pulmonary complication characterised by acute hypoxaemia and noncardiogenic pulmonary oedema following transfusion.
References
- Role of granulocyte transfusions in combating life-threatening infections in patients with severe neutropenia: Experience from a tertiary care centre in North India. PLOS ONE (2018).
- Dose-Dependent Effect of Granulocyte Transfusions in Hematological Patients with Febrile Neutropenia. PLOS ONE (2016).
- Granulocyte transfusions in children and adults with hematological malignancies: benefits and controversies. Journal of Translational Medicine (2015).
- Risk stratification by 30-day prognostic factors of clinical outcomes after granulocyte transfusion in acute myeloid leukemia: A single-center retrospective study. PLOS ONE (2022).
- Granulocyte Transfusion Therapy: Institutional Experience of Benefit in Cancer Patients with Prolonged Neutropenic Sepsis—A Retrospective Study. Indian Journal of Medical and Paediatric Oncology (2022).
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