Berlin Gösta, Cherif Honar, Knutson Folke, Mattsson Jonas, Axdorph Nygell Ulla
Universitetssjukhuset i Linkoping - Klinisk immunlogi och transfusionsmedicin Linkoping, Sweden Universitetssjukhuset i Linkoping - Klinisk immunlogi och transfusionsmedicin Linkoping, Sweden.
Akademiska sjukhuset - Hematologiska kliniken Uppsala, Sweden Akademiska sjukhuset - Hematologiska kliniken Uppsala, Sweden.
Lakartidningen. 2018 Mar 20;115:EXUU.
There are no randomized controlled trials proving the clinical benefit of granulocyte transfusions. However, clinical experience and a number of case studies suggest that granulocyte transfusions may be life-saving in certain situations. In our opinion granulocyte transfusions should be considered for patients with profound neutropenia and severe, life-threatening infection not responding to antibiotic or antifungal therapy. Since the clinical effect seems to be dose-dependent, the granulocyte concentrate should contain a large number of cells, which usually means that the donor should be mobilized with steroids and G-CSF. Regular blood donors as well as relatives to the patient can be used for granulocyte donations with apheresis technique after information of the process. Granulocyte transfusion should be given daily as long as the indication remains. The clinical efficacy of the transfusions should be evaluated daily.
尚无随机对照试验证明粒细胞输注具有临床益处。然而，临床经验和一些病例研究表明，粒细胞输注在某些情况下可能挽救生命。我们认为，对于严重中性粒细胞减少且患有严重的、危及生命的感染且对抗生素或抗真菌治疗无反应的患者，应考虑进行粒细胞输注。由于临床效果似乎与剂量相关，粒细胞浓缩液应含有大量细胞，这通常意味着供体应使用类固醇和粒细胞集落刺激因子进行动员。在告知过程后，可采用单采技术让定期献血者以及患者亲属进行粒细胞捐献。只要适应证仍然存在，粒细胞输注应每日进行。应每日评估输注的临床疗效。
