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Therapeutic Granulocyte Transfusions for Documented Infections: A Controlled Trial in Ninety-Five Infectious Granulocytopenic Episodes

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Grant support: grants HB-62971 from the National Heart, Lung, and Blood Institute, CA-23175 and CA-15688 from the National Cancer Institute, and AI-15322 from the National Institute of Allergy and Infectious Diseases. Dr. Gale is a Scholar of the Leukemia Society of America.

▸Requests for reprints should be addressed to Drew J. Winston, M.D.; Division of Infectious Diseases, Department of Medicine, UCLA Center for the Health Sciences; Los Angeles, CA 90024.

Los Angeles, California

© 1982 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1982;97(4):509-515. doi:10.7326/0003-4819-97-4-509
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Patients with granulocytopenia (granulocyte count less than 0.5 X 109/L) and a documented infection were randomized to receive or not to receive daily granulocyte transfusions in addition to antimicrobial therapy. Thirty-four of 47 control patients responded to therapy compared to 30 of 48 transfused patients (type 2 error, p = 0.02). Among patients with gram-positive septicemia, pneumonia, or a soft tissue infection, respective response rates for the control and transfused patients were 11 of 11 and 11 of 16 (Yates' corrected chi-squared test, p = 0.12). Response rates for patients with gram-negative septicemia were lower but were influenced by recovery of bone marrow function. Eleven of 12 control patients and seven of seven transfused patients with recovery of marrow function survived the gram-negative septicemia. In contrast, 12 of 24 control patients and 12 of 25 transfused patients survived gram-negative septicemia and persistent granulocytopenia (type 2 error, p = 0.13). Two thirds of all fatal infections were associated with an underlying disease refractory to medical therapy. Therapeutic granulocyte transfusions had no substantial benefit over optimal antimicrobial therapy alone in managing infected patients with granulocytopenia.





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