Istituto di Ematologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli, Roma, Italy.
U.O. Ematologia e Trapianto Midollo, IRCCS San Raffaele, Milano, Italy.
Biol Blood Marrow Transplant. 2017 Dec;23(12):2034-2041. doi: 10.1016/j.bbmt.2017.07.029. Epub 2017 Aug 7.
Granulocyte transfusions (GTs) are seldom used as a life-saving therapy for neutropenic patients with severe infections. Despite compelling evidence of GT efficacy in retrospective and prospective case series, no study has been successful in demonstrating a definite advantage for recipients in controlled clinical trials. This review critically revises some aspects emerging from past experience that might have weakened the evidence of GT benefits. Some specific issues relevant to the efficacy of this therapeutic approach, such as primary infection, delivered doses and schedules, and immunologic effects of GTs, are discussed. Importantly, the awareness of biologic effects accompanying the transfusion of neutrophils might support their use at standardized doses and may definitely convey significant advantages to the recipient patients.
粒细胞输注（GTs）很少作为中性粒细胞减少症伴严重感染患者的救命疗法使用。尽管在回顾性和前瞻性病例系列中，GT 疗效的证据确凿，但在对照临床试验中，没有一项研究成功证明对接受者有明确的益处。本综述批判性地回顾了过去经验中出现的一些可能削弱 GT 益处证据的方面。讨论了与这种治疗方法的疗效相关的一些具体问题，如原发性感染、给予的剂量和方案，以及 GT 的免疫效应。重要的是，对伴随中性粒细胞输注的生物学效应的认识可能支持以标准化剂量使用它们，并肯定会给接受者患者带来显著的优势。
