Cain Lorna, Lafrance Charles, Morton Suzy, Latour Catherine, Girard Mélissa, Tiberghien Pierre, de la Taille Virginie, Datta Suvro Sankha, Virk Mrigender Singh, Andrews Jennifer, Yahalom Vered, Pugliese Ana María, Alba Romina, Charlewood Richard, Kirwan Susy, Yokoyama Ana Paula Hitomi, Kutner Jose Mauro, Nogues Eva Alonso, Martinez I Llonch Nuria, Daly James, Irving David O, Schulze Torsten J, Huisman Elise, Le Poole Kaatje, Vrielink Hans, Saifee Nabiha H, Pagano Monica B, Stanworth Simon
Haematology/Transfusion Medicine, NHS Blood and Transplant and Oxford University Hospitals NHS Trust, Oxford, UK.
Nuffield Division of Clinical Laboratory Sciences, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
Transfusion. 2025 Jun;65(6):1111-1123. doi: 10.1111/trf.18263. Epub 2025 May 15.
Whether granulocytes for transfusion are beneficial remains uncertain, although some evidence suggests that efficacy may be dose-related. Granulocytes are mostly produced by apheresis procedure, but other means of production are increasingly used.
Centers that produce and/or use granulocytes were recruited through the BEST Collaborative and completed a detailed survey of granulocyte manufacture, specifications, clinical use, operational considerations, and data collection initiatives.
Fifteen national, regional, and local producers and/or users of granulocytes were included. Granulocytes were produced from apheresis procedure (n = 10), pooled buffy coats (n = 2), single buffy coats (n = 4) or pooling of residual leukocyte units from whole blood processing (n = 1). The mean adult dose of granulocytes reported was 1.6 to 3.7 × 10 for apheresis, and 1.8 to 2.2 × 10 for pooled buffy coat granulocytes. For apheresis procedure donations, donor stimulation included steroids and/or granulocyte colony-stimulating factor. Centers providing whole blood-derived granulocytes reported shorter times from request to delivery than those using apheresis procedure products. Indications and product selection criteria were similar. The most frequently reported challenges with granulocytes were donor availability for apheresis procedure (n = 7), short shelf life (n = 5) and lack of evidence of efficacy (n = 5). The cost of one unit of apheresis procedure granulocytes ranged from 568 to 7500 PPP-USD, and for one pooled buffy coat unit was from 2208 to 2822 PPP-USD.
We have highlighted differences in granulocyte production that are relevant for the design and interpretation of much needed international clinical studies.
尽管一些证据表明疗效可能与剂量相关，但输血用粒细胞是否有益仍不确定。粒细胞大多通过单采程序生产，但其他生产方式的使用也越来越多。
通过最佳协作组织招募了生产和/或使用粒细胞的中心，并对粒细胞生产、规格、临床应用、操作注意事项和数据收集举措进行了详细调查。
纳入了15个国家、地区和地方的粒细胞生产厂家和/或用户。粒细胞通过单采程序（n = 10）、混合白膜层（n = 2）、单个白膜层（n = 4）或全血处理中剩余白细胞单位的汇集（n = 1）生产。报告的成人粒细胞平均剂量，单采法为1.6至3.7×10，混合白膜层粒细胞为1.8至2.2×10。对于单采程序捐献，供体刺激包括使用类固醇和/或粒细胞集落刺激因子。提供全血来源粒细胞的中心报告称，从申请到交付的时间比使用单采程序产品的中心短。适应症和产品选择标准相似。粒细胞最常报告的挑战是单采程序的供体可用性（n = 7）、保质期短（n = 5）和缺乏疗效证据（n = 5）。一个单采程序粒细胞单位的成本在568至7500购买力平价美元之间，一个混合白膜层单位的成本在2208至2822购买力平价美元之间。
我们强调了粒细胞生产中的差异，这些差异与急需的国际临床研究的设计和解释相关。
