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08.09.2016 | Original Article | Ausgabe 10/2016

European Journal of Pediatrics 10/2016

Granulocyte transfusions in critically ill children with prolonged neutropenia: side effects and survival rates from a single-center analysis

European Journal of Pediatrics > Ausgabe 10/2016
Christina Weingarten, Sarah Pliez, Eva Tschiedel, Corinna Grasemann, Carla Kreissig, Michael M Schündeln
Wichtige Hinweise
Communicated by Patrick Van Reempts


Granulocyte transfusions for neutropenic patients have been used for over 40 years, although effectiveness, indications, and both patient and donor safety remain debated. This single-center study assessed the side effects, clinical course, and survival of granulocyte transfusions in critically ill pediatric patients, with underlying hemato-oncological disorders, prolonged neutropenia, and proven or suspected severe infection. Donor-specific side effects and influence of donor-specific characteristics on patient outcome were also investigated. A median of 4.02 × 1010 cells was collected from 39 healthy donors for 118 granulocyte concentrates. Donors reported no significant side effects. Complications for patients were frequent but mostly minor and included vomiting, hypotension, and dyspnea. In one episode of life-threatening dyspnea, association with the granulocyte transfusion could not be ruled out. Overall survival on day 100 was 61.9 %. Patients received a median of 0.13 × 1010 cells per kg body weight. Doses above this median were associated with a significantly better survival. Lower patient weight and age-/sex-adjusted weight were also associated with better survival.
Conclusion: Granulocyte mobilization and collection is a safe practice. Transfusions are well tolerated in critically ill patients. Patient weight and transfused cells per kg bodyweight are major determinants of survival in pediatric patients.
What is known:
Granulocyte transfusions for neutropenic patients have been used for over 40 years
The effectiveness of the technique remains controversial
Patient and donor safety remain debated
New mobilization protocols generate higher yields of granulocytes
What is new:
Granulocyte collection can safely be performed
Granulocytes can safely be administered to patients
Lower patient weight and age-/sex-adjusted weight are associated with better survival rates
Patients receiving above 0.13 × 10 10 cells per kg body weight had an excellent outcome
Further standardized, prospective studies are warranted

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