PMID- 38058170
OWN - NLM
STAT- Publisher
LR  - 20231207
IS  - 1592-8721 (Electronic)
IS  - 0390-6078 (Linking)
DP  - 2023 Dec 7
TI  - Granulocyte transfusions in severe aplastic anemia.
LID - 10.3324/haematol.2023.283826 [doi]
AB  - Patients with severe aplastic anemia (SAA) are at high risk for morbidity and 
      mortality due to severe infections. We aimed to characterize the role of 
      granulocyte transfusion (GT) in SAA. Primary outcomes were survival from first 
      GT, including overall survival (OS) at last follow up, survival to discharge, and 
      receipt of HSCT. Secondary outcomes included evaluation of clinical response at 7 
      and 30 days after GT initiation based on a clinical scoring system incorporating 
      microbiological and radiographic response. Twenty-eight SAA patients underwent 30 
      GT courses with a per-dose median of 1.28 x 109 granulocyte cells/kilogram (range 
      0.45-4.52 x 109). OS from initial GT to median last follow up (551 days) was 50%, 
      with 39% (11/28) alive at last follow up. Sixty-four percent (18/28) of all 
      patients survived to hospital discharge. Patients with complete, partial, or 
      stable response at 30 days had significantly improved OS compared to 
      non-responders (p=0.0004). Eighty-six percent (18/21) of patients awaiting HSCT 
      during GT underwent transplant and 62% (13/21) survived to post-HSCT discharge. 
      Sex, type of infection, or percentage of days with absolute neutrophil count > 
      0.2x109/L during GT course were not predictive of survival (p=0.52, p=0.7, 
      p=0.28). Nine of 28 (32%) patients developed new or increased human leukocyte 
      antigen (HLA) alloimmunization during their GT course. GTs in SAA may impact 
      survival in those with improvement or stabilization of their underlying 
      infection. Alloimmunization can occur and OS in this population remains poor, but 
      GTs may be a useful tool to bridge patients to curative treatment with HSCT.
FAU - Rajput, Roma V
AU  - Rajput RV
AD  - Hematology Branch, National Heart, Lung, and Blood Institute (NHLBI), National 
      Institutes of Health (NIH), Bethesda, MD. Roma.Rajput@nih.gov.
FAU - Shah, Vaani
AU  - Shah V
AD  - Hematology Consult and Graduate Medical Section, NHLBI, NIH, Bethesda, MD.
FAU - Shalhoub, Ruba N
AU  - Shalhoub RN
AD  - Office of Biostatistics Research, NHLBI, NIH, Bethesda, MD.
FAU - West-Mitchell, Kamille
AU  - West-Mitchell K
AD  - Department of Transfusion Medicine, Clinical Center, National Institutes of 
      Health, Bethesda, MD.
FAU - Cha, Nu Ri
AU  - Cha NR
AD  - Department of Transfusion Medicine, Clinical Center, National Institutes of 
      Health, Bethesda, MD.
FAU - Conry-Cantilena, Cathy
AU  - Conry-Cantilena C
AD  - Department of Transfusion Medicine, Clinical Center, National Institutes of 
      Health, Bethesda, MD.
FAU - Leitman, Susan F
AU  - Leitman SF
AD  - Department of Transfusion Medicine, Clinical Center, National Institutes of 
      Health, Bethesda, MD.
FAU - Young, David J
AU  - Young DJ
AD  - Translational Stem Cell Biology Branch, NHLBI, NIH, MD.
FAU - Wells, Brian
AU  - Wells B
AD  - Laboratory of Transplantation Immunotherapy, NHLBI, NIH, Bethesda, MD.
FAU - Aue, Georg
AU  - Aue G
AD  - Laboratory of Transplantation Immunotherapy, NHLBI, NIH, Bethesda, MD.
FAU - Dunbar, Cynthia E
AU  - Dunbar CE
AD  - Translational Stem Cell Biology Branch, NHLBI, NIH, MD.
FAU - Patel, Bhavisha A
AU  - Patel BA
AD  - Hematology Branch, National Heart, Lung, and Blood Institute (NHLBI), National 
      Institutes of Health (NIH), Bethesda, MD.
FAU - Childs, Richard W
AU  - Childs RW
AD  - Hematology Branch, National Heart, Lung, and Blood Institute (NHLBI), National 
      Institutes of Health (NIH), Bethesda, MD.
FAU - Young, Neal S
AU  - Young NS
AD  - Hematology Branch, National Heart, Lung, and Blood Institute (NHLBI), National 
      Institutes of Health (NIH), Bethesda, MD.
FAU - Wu, Colin O
AU  - Wu CO
AD  - Office of Biostatistics Research, NHLBI, NIH, Bethesda, MD.
FAU - Groarke, Emma M
AU  - Groarke EM
AD  - Hematology Branch, National Heart, Lung, and Blood Institute (NHLBI), National 
      Institutes of Health (NIH), Bethesda, MD.
FAU - Kalsi, Shelley S
AU  - Kalsi SS
AD  - Hematology Consult and Graduate Medical Section, NHLBI, NIH, Bethesda, MD.
LA  - eng
PT  - Journal Article
DEP - 20231207
PL  - Italy
TA  - Haematologica
JT  - Haematologica
JID - 0417435
SB  - IM
EDAT- 2023/12/07 06:42
MHDA- 2023/12/07 06:42
CRDT- 2023/12/07 03:41
PHST- 2023/07/28 00:00 [received]
PHST- 2023/12/07 06:42 [medline]
PHST- 2023/12/07 06:42 [pubmed]
PHST- 2023/12/07 03:41 [entrez]
AID - 10.3324/haematol.2023.283826 [doi]
PST - aheadofprint
SO  - Haematologica. 2023 Dec 7. doi: 10.3324/haematol.2023.283826.