Baykara Yigit, Jamal Yaseen, Nguyen AnhThu, Quach Thinh, Pandey Suchitra, Mateo Desireny, Yunce Muharrem
Pathology, Stanford University, Stanford, USA.
Transfusion Medicine, Stanford Health Care, Stanford, USA.
Cureus. 2025 May 6;17(5):e83578. doi: 10.7759/cureus.83578. eCollection 2025 May.
Background Granulocyte transfusion therapy has been explored as a potential treatment for severe neutropenia, particularly in patients with life-threatening infections unresponsive to conventional therapies. However, its clinical utility remains uncertain due to inconsistent evidence, challenges in donor availability, and risks of alloimmunization. Here, we evaluated granulocyte transfusions administered to 35 pediatric and adult patients at our institution. Materials and methods A retrospective chart review was conducted for 35 patients who received granulocyte transfusions between 2009 and 2024. Patient data included demographics, primary diagnosis, infection type, infection site, average granulocyte count in the units, average granulocyte dose, human leukocyte antigen-calculated panel reactive antibody (HLA-cPRA) Class I and II IgG antibodies, 42- and 90-day survival, average post-transfusion absolute neutrophil count (ANC) increment, and number of transfusions. Binomial logistic regression analysis was performed to determine the clinical variables associated with increased survival. Results Overall survival at 42 and 90 days was 21/35 (60%) and 20/35 (57%), respectively. No significant survival differences were observed based on infection type, diagnosis, or sex. Higher body weight, increased number of transfusions, and greater granulocyte dose per kilogram were associated with improved survival. While high-dose transfusions (≥0.6×10/kg) showed a trend toward better outcomes, statistical significance was not reached. HLA-cPRA Class I and II IgG antibodies correlated with lower ANC increments, though sample size limited definitive conclusions. Conclusion Granulocyte transfusions may benefit patients with severe neutropenia, particularly with higher doses. There are limited studies in the literature investigating the impact of HLA antibodies on ANC increment. In this study, we aimed to address this knowledge gap by providing our 16-year data from a single institution. Further prospective studies are needed to refine dosing strategies, assess the role of human leukocyte antigen alloimmunization, and optimize patient selection for improved clinical outcomes.
粒细胞输注疗法已被探索作为严重中性粒细胞减少症的一种潜在治疗方法，尤其是对于对传统疗法无反应的危及生命感染的患者。然而，由于证据不一致、供体可用性挑战以及同种免疫风险，其临床效用仍不确定。在此，我们评估了在我们机构接受粒细胞输注的35例儿科和成人患者。
对2009年至2024年间接受粒细胞输注的35例患者进行回顾性病历审查。患者数据包括人口统计学、主要诊断、感染类型、感染部位、单位中的平均粒细胞计数、平均粒细胞剂量、人类白细胞抗原计算的群体反应性抗体（HLA-cPRA）I类和II类IgG抗体、42天和90天生存率、输血后平均绝对中性粒细胞计数（ANC）增量以及输血次数。进行二项式逻辑回归分析以确定与生存率增加相关的临床变量。
42天和90天的总体生存率分别为21/35（60%）和20/35（57%）。基于感染类型、诊断或性别未观察到显著的生存差异。较高的体重、输血次数增加以及每千克更高的粒细胞剂量与生存率提高相关。虽然高剂量输血（≥0.6×10⁹/kg）显示出更好结果的趋势，但未达到统计学显著性。HLA-cPRA I类和II类IgG抗体与较低的ANC增量相关，尽管样本量限制了确定性结论。
粒细胞输注可能使严重中性粒细胞减少症患者受益，特别是更高剂量时。文献中关于HLA抗体对ANC增量影响的研究有限。在本研究中，我们旨在通过提供来自单一机构的16年数据来填补这一知识空白。需要进一步的前瞻性研究来完善给药策略、评估人类白细胞抗原同种免疫的作用并优化患者选择以改善临床结果。
