A Randomized Clinical Trial of Granulocyte Transfusions for Infection in Acute Leukemia

Authors:
  • JAJane B. Alavi
    Jane B. Alavi
  • RRRichard K. Root
    Richard K. Root
  • IDIsaac Djerassi
    Isaac Djerassi
  • AEAudrey E. Evans
    Audrey E. Evans
  • SGStephen J. Gluckman
    Stephen J. Gluckman
  • RMRob Roy MacGregor
    Rob Roy MacGregor
  • DGDuPont Guerry
    DuPont Guerry
  • ASAlan D. Schreiber
    Alan D. Schreiber
  • JSJohn M. Shaw
    John M. Shaw
  • PKPenelope Koch
    Penelope Koch
  • RCRichard A. Cooper
    Richard A. Cooper
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Abstract
In a prospective, controlled, randomized study to evaluate the efficacy of filtration-leukapheresis granulocytes in granulocytopenic, febrile patients with leukemia, 19 patients received antibiotics alone, and 12 received antibiotics plus daily granulocyte transfusions from ABO-matched donors. In skin-chamber studies the granulocytes appeared at sites of inflammation for at least six hours after transfusion. Infected subjects survived longer if they received granulocytes. Differences between control and transfused patients were greatest in patients with persistent bone-marrow failure, the 21-day survival being 20 per cent in controls, and 75 per cent in transfused patients. Granulocytes appeared to have no effect on the outcome of febrile episodes in which infection was not documented, the 21-day survival being 79 percent for controls and 88 per cent for transfused patients. The transfusion of granulocytes thus appears to offer a survival advantage to infected, persistently granulocytopenic patients. (N Engl J Med 296:706–711, 1977)