Granulocyte-colony-stimulating factor-mobilized prophylactic granulocyte transfusions given after allogeneic peripheral blood progenitor cell transplantation result in a modest reduction of febrile days and intravenous antibiotic usage

Aarti Oza, Chris Hallemeier, Lawrence Goodnough, Hanna Khoury, Shalini Shenoy, Steven Devine, Kristan Augustin, Ravi Vij, Kathryn Trinkaus, John F. DiPersio, Douglas Adkins

Research output: Contribution to journalArticle

41 Scopus citations

Abstract

BACKGROUND: It was hypothesized that transfusion of two granulocyte-colony-stimulating factor (G-CSF)-mobilized prophylactic granulocyte components into allogeneic peripheral blood progenitor cell (PBPC) transplant patients during the regimen-related neutropenic interval would result in clinical benefit. STUDY DESIGN AND METHODS: HLA-matched sibling PBPC donors (n = 151) were biologically randomized based on ABO mismatch to donate granulocyte components (Cohort G) or not donate granulocytes (control group, Cohort C). ABO-matched donors who did not meet other study-specific criteria were reassigned to Cohort C. RESULTS: Feasibility, defined as the proportion of ABO-matched donors who underwent granulocyte collections, was 42 percent (53 of 125). The percentage of patients who developed fever during the initial hospitalization was greater in Cohort C versus Cohort G (82.7% vs. 64.2%; p = 0.03). In the interval from when granulocyte transfusions were initially given in Cohort G (Day +3 or Day +5) until neutrophil engraftment, the number of febrile days was less in Cohort G versus Cohort C (median, 0 vs. 1; Mann-Whitney p = 0.003). The median number of days of intravenous antibiotics given during the initial hospitalization was less in Cohort G versus Cohort C (9 vs. 11; Mann-Whitney p = 0.03), a difference accounted for in the interval from Day +3 or Day +5 to neutrophil recovery. There was no significant difference in length of the initial hospital stay, acute graft-versus-host disease rates, or 100-day survival between the two cohorts. CONCLUSION: This prospective study demonstrates a modest, but significant, benefit of G-CSF-mobilized HLA-matched prophylactic granulocyte transfusions in neutropenic allogeneic PBPC recipients.

Original languageEnglish (US)
Pages (from-to)14-23
Number of pages10
JournalTransfusion
Volume46
Issue number1
DOIs
StatePublished - Jan 2006

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Hematology

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