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Granulocyte–colony‐stimulating factor–mobilized prophylactic granulocyte transfusions given after allogeneic peripheral blood progenitor cell transplantation result in a modest reduction of febrile days and intravenous antibiotic usage
Author(s) -
Oza Aarti,
Hallemeier Chris,
Goodnough Lawrence,
Khoury Hanna,
Shenoy Shalini,
Devine Steven,
Augustin Kristan,
Vij Ravi,
Trinkaus Kathryn,
DiPersio John F.,
Adkins Douglas
Publication year - 2006
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2005.00665.x
Subject(s) - medicine , cohort , granulocyte colony stimulating factor , transplantation , surgery , granulocyte , prospective cohort study , regimen , chemotherapy
BACKGROUND: It was hypothesized that transfusion of two granulocyte–colony‐stimulating factor (G‐CSF)‐mobilized prophylactic granulocyte components into allogeneic peripheral blood progenitor cell (PBPC) transplant patients during the regimen‐related neutropenic interval would result in clinical benefit. STUDY DESIGN AND METHODS: HLA‐matched sibling PBPC donors (n = 151) were biologically randomized based on ABO mismatch to donate granulocyte components (Cohort G) or not donate granulocytes (control group, Cohort C). ABO‐matched donors who did not meet other study‐specific criteria were reassigned to Cohort C. RESULTS: Feasibility, defined as the proportion of ABO‐matched donors who underwent granulocyte collections, was 42 percent (53 of 125). The percentage of patients who developed fever during the initial hospitalization was greater in Cohort C versus Cohort G (82.7% vs. 64.2%; p = 0.03). In the interval from when granulocyte transfusions were initially given in Cohort G (Day +3 or Day +5) until neutrophil engraftment, the number of febrile days was less in Cohort G versus Cohort C (median, 0 vs. 1; Mann‐Whitney p = 0.003). The median number of days of intravenous antibiotics given during the initial hospitalization was less in Cohort G versus Cohort C (9 vs. 11; Mann‐Whitney p = 0.03), a difference accounted for in the interval from Day +3 or Day +5 to neutrophil recovery. There was no significant difference in length of the initial hospital stay, acute graft‐versus‐host disease rates, or 100‐day survival between the two cohorts. CONCLUSION: This prospective study demonstrates a modest, but significant, benefit of G‐CSF–mobilized HLA‐matched prophylactic granulocyte transfusions in neutropenic allogeneic PBPC recipients.