Department of Pediatrics, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan.
Tokai J Exp Clin Med. 2022 Sep 20;47(3):136-138.
Granulocyte transfusions (GTX) have been used in patients with neutropenia or neutropenia associated with invasive fungal infection. An 11-year-old girl with severe aplastic anemia (SAA) received immunosuppressive therapy (IST) with rabbit antithymocyte globulin, cyclosporine, and granulocyte colony-stimulating factor. However, IST was not effective and her condition became complicated with life-threatening invasive pulmonary aspergillosis. Owing to the necessity for early neutrophil recovery to resolve the infection, GTX were performed, followed by bone marrow transplantation (BMT) from her mother with human leukocyte antigen-B locus mismatch. Her dyspnea improved and she eventually became afebrile after the initiation of GTX. Despite engraftment failure following BMT, successful engraftment was achieved by salvage therapy with peripheral blood stem cell transplantation. Chest computed tomography scan obtained 4 months after BMT revealed marked improvement in pneumonia. The current case illustrates that GTX may be useful in controlling invasive fungal infections before hematopoietic stem cell transplantation in patients with SAA.
粒细胞输注（GTX）已用于中性粒细胞减少或与侵袭性真菌感染相关的中性粒细胞减少症患者。一名 11 岁女孩患有严重再生障碍性贫血（SAA），接受了兔抗胸腺细胞球蛋白、环孢素和粒细胞集落刺激因子的免疫抑制治疗（IST）。然而，IST 无效，她的病情变得复杂，出现危及生命的侵袭性肺曲霉病。由于需要早期中性粒细胞恢复以解决感染，因此进行了 GTX，随后进行了来自母亲 HLA-B 座不匹配的同种异体骨髓移植（BMT）。GTX 开始后，她的呼吸困难得到改善，最终不再发热。尽管 BMT 后发生移植物植入失败，但通过外周血干细胞移植挽救治疗成功实现了植入。BMT 后 4 个月进行的胸部计算机断层扫描显示肺炎明显改善。本病例表明，在 SAA 患者进行造血干细胞移植前，GTX 可能有助于控制侵袭性真菌感染。
