Neutrophil (Granulocyte) Transfusions

Published on 22/03/2015 by admin

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Last modified 22/03/2015

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Chapter 466 Neutrophil (Granulocyte) Transfusions

Ronald G. Strauss

Guidelines for granulocyte transfusion (GTX) are listed in Table 466-1image on the Nelson Textbook of Pediatrics website at www.expertconsult.com. Although GTX has been used sparingly in the past, the ability to collect markedly higher numbers of neutrophils from donors stimulated with recombinant granulocyte colony-stimulating factor (G-CSF) plus dexamethasone has led to renewed interest, particularly for recipients of hematopoietic progenitor cell transplantation. GTX should be reconsidered at institutions where neutropenic patients continue to die of progressive bacterial and fungal infections or to suffer substantial morbidity despite the optimal use of antimicrobial agents (i.e., “antibiotics”) and recombinant myeloid growth factors.

Table 466-1 GUIDELINES FOR PEDIATRIC GRANULOCYTE TRANSFUSIONS*

CHILDREN AND ADOLESCENTS

Severe neutropenia (blood neutrophil count <0.5 × 109/L) and infection (bacterial, yeast, or fungal) unresponsive or progressive despite appropriate antimicrobial therapy.
Qualitative neutrophil defect and infection (bacterial or fungal) unresponsive to appropriate antimicrobial therapy

INFANTS ≤4 MO OLD

Blood neutrophil count <3.0 × 109/L in 1st wk of life or <1.0 × 109/L thereafter and fulminant bacterial infection

* Words in italics

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