Granulocyte transfusion therapy in pediatric patients after hematopoietic stem cell transplantation: a 5-year single tertiary care center experience.

BACKGROUND: Granulocyte transfusion (GTx) has been used in neutropenic patients to treat infections; however, there are few studies that document its efficacy, especially in pediatric patients after hematopoietic stem cell transplantation (HSCT). We, therefore, reviewed the use of GTx in these patients. MATERIALS AND METHODS: A retrospective observational analysis was performed on all pediatric HSCT patients between January 2005 and January 2010 who met our institution's criteria for GTx and received more than 1 GTx. Unstimulated granulocyte donors were used until June 2007, followed by dexamethasone-stimulated donors thereafter. Outcomes were infection clearance, safety profile of GTx, and 30-day survival. RESULTS: One hundred fifty-three GTxs were administered to 16 pediatric HSCT patients. Indications for GTx: bacterial (69%), fungal (19%), and combined infection (12%). Concurrent infections, mostly bacterial, developed in 60% patients. One adverse reaction (pulmonary toxicity) was reported. The absolute neutrophil count of the stimulated products was significantly higher compared with the unstimulated products; however, neither the average number of granulocytes transfused by weight nor outcomes difference was noticed between these groups. CONCLUSIONS: GTx is safe in neutropenic and infected pediatric patients after HSCT. However, no difference in the outcomes was noticed between the group that received stimulated products and the group that received unstimulated products.