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Granulocyte transfusions

Dennis Goldfinger, MD
Qun Lu, MD
Section Editor
Arthur J Silvergleid, MD
Deputy Editor
Alan G Rosmarin, MD


In spite of modern antimicrobials and supportive therapy, bacterial, fungal, and viral infections are still major complications in patients with prolonged disease-related or therapy-related neutropenia. An increasing number of clinical disorders are being treated with aggressive chemotherapy and bone marrow or hematopoietic stem cell transplantation. Neutropenia is one of the most frequent side effects of these aggressive treatments, and the risk of infection increases rapidly when the granulocyte count falls below 500 cells/microL (table 1). (See "Approach to the adult with unexplained neutropenia", section on 'Determining risk of infection' and "Overview of neutropenia in children and adolescents".)

The spectrum of infections in neutropenic patients has shifted, with multidrug-resistant bacterial infection and fungal infection such as Aspergillus, Fusarium, and Zygomyces emerging as the main cause of morbidity and mortality [1]. Since these infections are the direct result of neutropenia, granulocyte transfusion (GTX) as replacement therapy is a logical therapeutic approach and has been available for the last 40 years.

The history, indications, clinical efficacy, and complications of GTX will be reviewed here, as well as donor selection, qualification, stimulation, granulocyte collection, processing, storage, and transfusion.

Separate topic reviews discuss evaluation and general management of patients with fever and neutropenia.

(See "Overview of neutropenic fever syndromes".)

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Literature review current through: Nov 2017. | This topic last updated: Apr 25, 2016.
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