Filtration Leukapheresis for Granulocyte Transfusion Therapy: Clinical and Laboratory Studies

Donald J. Higby, Jerome W. Yates, Edward S. Henderson, James F. Holland

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197 Scopus citations

Abstract

To study the clinical efficacy of granulocytes obtained by filtration leukapheresis, patients with clinically evident infection and granulocyte counts of < 500 per cubic millimeter were randomly assigned to receive conventional therapy alone or with a granulocyte transfusion obtained from a single donor each day for four days. Five of 19 control patients survived to day 20, and 15 of 17 in the transfused group survived. Comparison of the two populations for variables such as age, disease, and severity and type of infection revealed no other factor that could account for the difference in survival. Outcome was not demonstrated to be related to HL-A match, post-transfusion counts, or presence of leukocyte antibodies. Functional studies of granulocytes obtained by filtration leukapheresis showed only minor differences although appearance was altered. Granulocytes so obtained can be used safely and efficaciously as adjunctive therapy for infection associated with granulocytopenia. (N Engl J Med 292: 761–766, 1975). THE major cause of death in patients whose bone-marrow function is compromised by neoplastic disease, chemotherapy or radiation therapy is infection, which, despite the use of broad-spectrum antibiotics, still accounts for the majority of deaths in patients with hematologic cancers.12Isolator systems are neither therapeutic for patients who have already acquired infections nor, in fact, uniformly successful in preventing infections in granulocytopenic, leukemic patients.3 4 5Freireich et al. demonstrated that transfusions of large numbers of granulocytes from patients with chronic granulocytic leukemia into leukopenic recipients could increase the circulating granulocyte count, and further showed a correlation between defervescence and granulocyte transfusions.

Original languageEnglish
Pages (from-to)761-766
Number of pages6
JournalNew England Journal of Medicine
Volume292
Issue number15
DOIs
StatePublished - 10 Apr 1975
Externally publishedYes

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