Introduction: Several studies have shown that granulocyte transfusions improved the survival rate of infected neutropenic immunosuppressed cancer patients when given in a high component cell dose. Many other factors may also affect the outcome of these transfusions such as leukocyte compatibility that needs to be evaluated.Purpose: To determine if leukocyte compatibility has a significant effect to the outcome of these patients.Methods:Lymphocytotoxicity screening assay (LCA)against a panel of HLA- defined cells was used to evaluate leukocyte compatibility. This test is designed to detect the presence of complement-dependent cytotoxic antibodies in the serum of patients, which could immunologically destroy white blood cells and /or their precursor cells. The test was performed in patients and donors before the granulocyte collections and transfusions respectively.All donors were mobilized with G-CSF. The recipients were transfused with at least 2 units of granulocytes.A total of 14 patients were in this study.Ages range from 25-77, 8 males and 6 females with the following diagnoses:AML,7; MM,1;ALL,1:CLL,11;MDS,1;Ovarian CA,1.The indications for transfusions were:pneumonia(fungal,7;Pseudomonas,1),Fungemia,3;Neutropenic colitis,1;Invasive aspergillosis,1;Fungal Sinusitis,1.Seven patients received ABO compatible and incompatible units,5 with only ABO compatible units and 1 with only incompatible units.Results: Only one recipient had a positive LCA. This patient was transfused with 6 ABO compatible units. The mean 1 and 24 hours post transfusion increases in ANC for LCA negative recipients were 0.88 K/UL (range 0-3.65 K/ul) and 1.05 K/UL (range 0-3.95 K/UL), respectively. The comparable values for LCA positive recipient were 0.77 K/UL (range 0-0.9 K/UL) and 0.60 K/UL (range 0-0.80 IU/K). There was no transfusion reaction reported. Conclusion: Leukocyte compatibility may not play a significant role in granulocyte transfusions in the setting of severely immunocompromized neutropenic cancer patients requiring support to fight infection.More studies are needed.
Full conference title:
43rd American Society of Hematology (ASH) Annual Meeting
- ASH 43rd (2001)