Top

Published in:

01-11-2005 | Original Article

Prophylactic and interventional granulocyte transfusions in patients with haematological malignancies and life-threatening infections during neutropenia

Authors: Sabine Mousset, Stella Hermann, Stefan A. Klein, Heike Bialleck, Michaele Duchscherer, Barbara Bomke, Barbara Wassmann, Angelika Böhme, Dieter Hoelzer, Hans Martin

Published in: Annals of Hematology | Issue 11/2005

Abstract

Patients with haematological malignancies and prolonged periods of neutropenia after chemotherapy are at high risk for severe bacterial and fungal infections. Those infections have long time been considered as a contraindication for subsequent haematopoietic stem cell transplantation (HCT). We conducted a prospective, non-randomized study of granulocyte transfusions (GTX) to control acute life-threatening infections (44 episodes) and to prevent recurrence of severe fungal infections during HCT or intensive chemotherapy (23 episodes). GTX achieved control in 82% (36/44) of acute life-threatening infections. No single reactivation of a previous infection occurred under prophylactic GTX (0/23). Median survival was 170 days in the interventional group and 185 days in the prophylactic group; death in both patient groups was mainly due to underlying progressive malignant disease. We conclude that under GTX, the infection-related mortality even in high-risk patients is low. Due to a secondary prophylaxis with GTX, haematopoietic allografts can be safely given to patients with previous fungal infections.

Adkins DR, Goodnough LT, Moellering J, Brown R, Khoury H, Vij R, DiPersio J (1999) Reduction in antibiotic utilization and of febrile days by transfusion of G-CSF mobilized prophylactic granulocyte components: a randomised study. Blood 94:590a

Adkins DR, Goodnough LT, Shenoy S, Brown R, Moellering J, Khoury H, Vij R, DiPersio J (2000) Effect of leukocyte compatibility on neutrophil increment after transfusion of granulocyte colony-stimulating factor-mobilized prophylactic granulocyte transfusions and on clinical outcomes after stem cell transplantation. Blood 95:3605–3612PubMed

Ascioglu S, Rex JH, de Pauw B, Bennett JE, Bille J, Crokaert F, Denning DW, Donnelly JP, Edwards JE, Erjavec Z, Fiere D, Lortholary O, Maertens J, Meis JF, Patterson TF, Ritter J, Selleslag D, Shah PM, Stevens DA, Walsh TJ (2002) Defining opportunistic invasive fungal infections in immunocompromised patients with cancer and haematopoietic stem cell transplants: an international consensus. Clin Infect Dis 34:7–14CrossRefPubMed

Bensinger WI, Price TH, Dale DC, Appelbaum FR, Clift R, Lilleby K, Williams B, Storb R, Thomas ED, Buckner CD (1993) The effects of daily recombinant human granulocyte colony-stimulating factor administration on normal granulocyte donors undergoing leukapheresis. Blood 81:1883–1888PubMed

Blum W, Hallem C, Vij R, Shenoy S, Goodnough L, Brown R, Khoury H, Westervelt P, DiPersio J, Adkins D (2001) Improved survival in allogeneic peripheral blood stem cell (PBSC) transplant recipients who received prophylactic granulocyte transfusions from HLA-matched donors: long-term follow-up. Blood 98:58a

Bodey GP, Buckley M, Sathe YS, Freireich EJ (1966) Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Ann Intern Med 64:328–340PubMed

Bux J, Dielschneider T, Duscherer M, Edel E, Eichler H, Haas C, Moog R, Peschke H, Peters C, Ryzenkov I, Schlenke P, Ullrich H, Wiesneth M (2003) Tolerance of granulocyte donors towards granulocyte colony-stimulating factor stimulation and of patients towards granulocyte transfusions: results of a multicentre study. Vox Sang 85:322–325CrossRefPubMed

Caspar CB, Seger RA, Burger J, Gmür J (1993) Effective stimulation of donors for granulocyte transfusions with recombinant methionyl granulocyte colony-stimulating factor. Blood 81:2866–2871PubMed

Cordonnier C, Maury S, Pautas C, Bastié JN, Chehata S, Castaigne S, Kuentz M, Bretagne S, Ribaud P (2004) Secondary antifungal prophylaxis with voriconazole to adhere to scheduled treatment in leukemic patients and stem cell transplant recipients. Bone Marrow Transplant 33:943–948CrossRefPubMed

10.

Denning DW (1998) Invasive aspergillosis. Clin Infect Dis 26:781–803PubMed

11.

Dignani MC, Anaissie EJ, Hester JP, O’Brien S, Vartivarian SE, Rex JH, Kantarjian H, Jendiroba DB, Lichtiger B, Nadersson BS, Freireich EJ (1997) Treatment of neutropenia-related fungal infections with granulocyte colony-stimulating factor-elicited white blood cell transfusions : a pilot study. Leukemia 11:1621–1630CrossRefPubMed

12.

Freireich EJ, Levin RH, Whang J, Carbone PP, Bronson W, Morse EE (1964) The function and fate of transfused leukocytes from donors with chronic myelocytic leukemia in leukopenic patients. Ann NY Acad Sci 113:1081–1090PubMed

13.

Herbrecht R, Denning DW, Patterson TF, Bennett JE, Greene R, Oestmann JW, Kern WV, Marr KA, Ribaud P, Lortholary O, Sylvester R, Rubin RH, Wingard JR, Stark P, Durand C, Caillot D, Thiel E, Chandrasekar PH, Hodges MR, Schlamm HAT, Troke PF, De Pauw B (2002) Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med 347:408–415CrossRefPubMed

14.

Hermann S, Klein SA, Jacobi V, Thalhammer A, Bialleck H, Duchscherer M, Wassmann B, Hoelzer D, Martin H (2001) Older patients with high-risk fungal infections can be successfully allografted using non-myeloablative conditioning in combination with intensified supportive care regimens. Br J Haematol 113:446–454CrossRefPubMed

15.

Hübel K, Carter RA, Liles WC, Dale DC, Price TH, Bowden RA, Rowley RD, Chauncey TR, Bensinger WI, Boeckh M (2002) Granulocyte transfusion therapy for infections in candidates and recipients of HPC transplantation: a comparative analysis of feasibility and outcome for community donors versus related donors. Transfusion 42:1414–1421CrossRefPubMed

16.

Illerhaus G, Wirth A, Dwenger A, Waller CF, Garbe A, Brass V, Lang H, Lange W (2002) Treatment and prophylaxis of severe infections in neutropenic patients by granulocyte transfusions. Ann Hematol 81:273–281CrossRefPubMed

17.

Kerr JP, Liakopolou E, Brown J, Cornish JM, Fleming D, Massey E, Oakhill A, Pamphilon DH, Robinson SP, Totem A, Valencia AMP, Marks DI (2003) The use of stimulated granulocyte transfusions to prevent recurrence of past severe infections after allogenic stem cell transplantation. Br J Haematol 123:114–118CrossRefPubMed

18.

Klein SA, Hermann S, Dietrich CF, Hoelzer D, Martin H (2002) Transplantation-related toxicity and acute intestinal graft-versus-host disease after conditioning regimens intensified with Rhenium 188-labeled anti-CD66 monoclonal antibody. Blood 99:2270–2271CrossRefPubMed

19.

Lee JJ, Chung IJ, Park MR, Kook H, Hwang TJ, Ryang DW, Kim HJ (2001) Clinical efficacy of granulocyte transfusion therapy in patients with neutropenia-related infections. Leukemia 15:203-207CrossRefPubMed

20.

Offner F, Cordonnier C, Ljungmann P, Prentice HG, Engelhard D, De Bacquer D, Meunier F, De Pauw B (1998) Impact of previous aspergillosis on the outcome of bone marrow transplantation. Clin Infect Dis 26:1098–1103PubMed

21.

Peters C, Minkov M, Matthes-Martin S, Pötschger U, Witt V, Mann G, Höcker P, Worel N, Stary J, Klingebiel T, Gadner H (1999) Leucocyte transfusions from rhG-CSF or prednisolone stimulated donors for treatment of severe infections in immunocompromised patients. Br J Haematol 106:689–696CrossRefPubMed

22.

Price TH, Raleigh AB, Boeckh M, Bux J, Nelson K, Liles C, Dale DC (2000) Phase I/II trial of neutrophil transfusions from donors stimulated with G-CSF and dexamethasone for treatment of patients with infections in hematopoietic stem cell transplantation. Blood 95:3302–3309PubMed

23.

Robinson SP, Marks DI (2004) Granulocyte transfusions in the G-CSF era. Where do we stand? Bone Marrow Transplant 34:839–846CrossRefPubMed

24.

Rutella S, Pierelli L, Piccirillo N, Sica S, Serafini R, Chiusolo P, Paladini U, Leone F, Zini G, D’Onofrio G, Leone G (2003) Efficacy of granulocyte transfusions for neutropenia-related infections: retrospective analysis of predictive factors. Cytotherapy 5:19–30CrossRefPubMed

25.

Strauss RG (1995) Clinical perspectives of granulocyte transfusions: efficacy to date. J Clin Apher 10:114–118

26.

Vamvakas EC, Pineda AA (1996) Meta-analysis of clinical studies of the efficacy of granulocyte transfusions in the treatment of bacterial sepsis. J Clin Apher 11:1–9CrossRef

27.

Vij R, DiPersio JF, Venkatraman P, Trinkaus K, Goddnough LT, Brown RA, Khoury HJ, Devine SM, Oza A, Shenoy S, Blum W, Adkins D (2003) Donor CMV serostatus has no impact on CMV viremia or disease when prophylactic granulocyte transfusions are given following allogenic peripheral blood stem cell transplantation. Blood 101:2067–2069CrossRefPubMed

Title: Prophylactic and interventional granulocyte transfusions in patients with haematological malignancies and life-threatening infections during neutropenia
Authors: Sabine Mousset
Stella Hermann
Stefan A. Klein
Heike Bialleck
Michaele Duchscherer
Barbara Bomke
Barbara Wassmann
Angelika Böhme
Dieter Hoelzer
Hans Martin
Publication date: 01-11-2005
Publisher: Springer-Verlag
Published in: Annals of Hematology / Issue 11/2005
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-005-1055-z

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 11/2005

A case of deep vein thrombosis in patient with Hermansky–Pudlak syndrome

Colony-stimulating factors in the management of neutropenia and its complications

Mesenchymal stem cells obtained after bone marrow transplantation or peripheral blood stem cell transplantation originate from host tissue

Liver transplantation after stem cell transplantation with the same living donor in a monozygotic twin with acute myeloid leukemia

Prospective randomized comparative observation of single- vs split-dose lenograstim to mobilize peripheral blood progenitor cells following chemotherapy in patients with multiple myeloma or non-Hodgkin’s lymphoma

Transdifferentiation of mesenchymal stem cells into cardiomyocytes by direct cell-to-cell contact with neonatal cardiomyocyte but not adult cardiomyocytes

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials