G-CSF mobilised granulocyte transfusions in 32 paediatric patients with neutropenic sepsis
Autor: | Karl Welte, Lilia Goudeva, Hans-Gert Heuft, Kathrin Seidemann, Andreas Beilken, Christin Linderkamp, Nicole Pulver, Hansjörg Schmid, Lorenz Grigull, Karl-Walter Sykora |
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Jazyk: | angličtina |
Rok vydání: | 2006 |
Předmět: |
Male
Antibiotics Leukocyte Count Germany Granulocyte Colony-Stimulating Factor Child Granulocyte transfusion Mortality rate Hematopoietic Stem Cell Transplantation Precursor Cell Lymphoblastic Leukemia-Lymphoma Recombinant Proteins Leukocyte Transfusion medicine.anatomical_structure C-Reactive Protein Treatment Outcome Oncology Leukemia Myeloid Child Preschool Hematologic Neoplasms Acute Disease Blood Component Removal Original Article Female medicine.medical_specialty Neutropenia Adolescent medicine.drug_class Context (language use) Antineoplastic Agents Granulocyte G-CSF Sepsis Internal medicine medicine Humans Gram-Positive Bacterial Infections Retrospective Studies business.industry Infant medicine.disease Survival Analysis Surgery Transplantation Lenograstim Mycoses business Gram-Negative Bacterial Infections Biomarkers Follow-Up Studies Granulocytes |
Zdroj: | Supportive Care in Cancer |
ISSN: | 1433-7339 0941-4355 |
Popis: | Introduction In this retrospective, uncontrolled, observational study, the effect of granulocyte colony-stimulating factor (G-CSF)-stimulated granulocyte transfusions (GTX) in neutropenic paediatric patients with sepsis was evaluated. Patients and methods Granulocytes were collected from unrelated, ABO group-matched and cytomegalic-antibody compatible donors. For neutrophil mobilization, donors received a single subcutaneous dose of glycosylated G-CSF (Lenograstim, Chugai Pharma, Japan) plus oral dexamethasone (8 mg). In total, 168 (range 1–19 per patient) GTX were transfused in 32 children with a median age of 7.4 (0.25 to 16) years. Results The underlying diseases comprised predominantly haematooncological malignancies (31 children). In 15 of 32 patients, neutropenia was related to allogeneic stem cell transplantation. All children suffered from sepsis based on international criteria (fever, tachycardia, respiratory rate >2 SD above normal in the context of a suspected or proven infection). In ten children bacteria were isolated, in six children a fungal infection was diagnosed and four sepsis episodes were caused by viral infections. GTX contained a median neutrophil number of 6.3 (range 1.9–13.9)×1010 per transfusion and obtained a sustained haematological response after GTX. Nineteen out of 32 children survived the neutropenic sepsis, particularly nine out of 11 patients with bacterial sepsis. Discussion In contrast to the non-survivors, we observed a significant decrease in the C-reactive protein levels shortly after initiation of the GTX treatment in the surviving patients. A clear-cut benefit of GTX for children with neutropenic sepsis cannot be concluded from these data, but in children with (severe) bacterial sepsis refractory to antibiotic treatment, GTX were feasible, safe and could reduce mortality rates in this subgroup of patients. |
Databáze: | OpenAIRE |
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