Granulocyte Concentrate reduces mortality and benefits neutropenic children with severe infections: Study

Infections remain the leading cause of mortality among neutropenic patients with haematologic malignancies, making effective infection management crucial. Achieving a sufficient neutrophil count is essential for the elimination of pathogens. Granulocyte concentrate (GC) can be a treatment option for neutropenic patients with severe infections.

This study aimed to evaluate the efficacy, safety, and impact on survival of Granulocyte Concentrate transfusions in neutropenic children with severe infections treated over the past 13 years in a single centre. Methods: The retrospective study analysed clinical data from 60 children (median age 9.5 years) who received Granulocyte concentration transfusions at our centre. Granulocytes were collected by apheresis from donors stimulated with granulocyte colony-stimulating factor. The majority of the patients (70%) were diagnosed with acute leukaemia.

The main indications for Granulocyte Concentrate were severe pneumonia (45%) and bacterial sepsis (38.33%). Results: The patients received 1 to 29 Granulocyte Concentrate transfusions for 1 to 70 days, with a median time of administration of 3 days. Neutrophil counts increased to >1000/µL within a median of 5 days. Granulocyte concentrations were well tolerated by most patients. One patient presented symptoms of anaphylaxis, the other acute lung injury related to transfusions, and alloimmunisation was reported in one patient. Of the patients analysed, 78.33% survived the infection that justified Granulocyte Concentrate administration.

They did not observe significant differences in survival depending on the aetiology of the infection. Conclusions: Based on our research, Granulocyte Concentrate appears to be a beneficiary for neutropenic children with severe infections and reduces infection mortality rates. However, further well-designed randomised trials are needed to define its role in this setting.

Reference:

Mielecka-Jarmocik, Gabriela, et al. "Use of Granulocyte Transfusions in the Management of Severe Infections Among Children With Neutropenia." Journal of Personalized Medicine, vol. 14, no. 11, 2024.