Leucocyte transfusions from rhG-CSF or prednisolone stimulated donors for treatment of severe infections in immunocompromised neutropenic patients

被引:100
作者
Peters, C
Minkov, M
Matthes-Martin, S
Pötschger, U
Witt, V
Mann, G
Höcker, P
Worel, N
Stary, J
Klingebiel, T
Gadner, H
机构
[1] St Anna Childrens Hosp, Bone Marrow Transplantat Unit, A-1090 Vienna, Austria
[2] Univ Vienna, Clin Blood Grp Serol & Transfus, Vienna, Austria
[3] Univ Hosp Motol, Prague, Czech Republic
[4] Univ Tubingen, Pediat Clin, Tubingen, Germany
关键词
infection; leucocyte; transfusion; granulocytes; rhG-CSF;
D O I
10.1046/j.1365-2141.1999.01619.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Sepsis in profound neutropenia after chemotherapy is associated with high mortality despite appropriate antibacterial or antifungal treatment. In a prospective phase I/II study we evaluated the feasability and efficacy of leucocyte transfusions (LT) in patients with malignancies or haematological disorders who were suffering from severe bacterial or fungal infection during therapy-related bone marrow aplasia. 30 patients with severe neutropenia and clinical signs of life-threatening sepsis not responding to adequate treatment, received LT from rhG-CSF-stimulated family donors or from prednisolone-primed volunteers. A total of 301 LT were administered. The median number of LT per patient was seven (range three to 65), the median duration of LT treatment was 8 d (range 2-35), The white cell count (WBC), absolute neutrophil count (ANC) and lymphocyte count of the concerntrates from ehG-CSF- stimulated donors were sinificantly higher than those from prednisolone-primed volunteers (P=0.0001). Despite the critical condition of the patients, LT were generally well tolerated. Only 39 (12.9%) LT were associated with adverse reactions. The transfusion of leucocytes collected by continuous flow leukapheresis from both rhG-CSF and prednisolone stimulated donors resulted in a measurable increment of the peripheral leucocyte and ANC counts in our patients. On day 100 after the first LT, 20/30 patients were alive with complete clearance of the infection.
引用
收藏
页码:689 / 696
页数:8
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