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
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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