Matsue K, Harada M, Nakao S, Ueda M, Kondo K, Odaka K, Mori T, Hattori K
Jpn J Clin Oncol. 1984 Mar;14(1):21-30.
The effectiveness of therapeutic granulocyte transfusions was studied in a controlled trial involving 75 granulocytopenic patients with severe infections. Patients who had granulocyte counts of less than 200/mm3 and no response to antibiotic therapy were assigned to receive antibiotic therapy alone or granulocyte transfusions plus antibiotic therapy. Granulocytes were collected by filtration leukapheresis (FL), intermittent flow centrifuge leukapheresis (IFCL) or continuous flow centrifuge leukapheresis (CFCL). Therapeutic effects of granulocyte transfusions were evaluated on the basis of 20-day survival after entry into the study. The patients were divided into three groups: 1) 22 patients received antibiotic therapy alone for 29 infectious episodes (control group); 2) 27 patients received 131 transfusions of granulocytes collected by FL for 31 infectious episodes (FL group); 3) 26 patients received 139 transfusions of granulocytes collected by IFCL and CFCL for 27 infectious episodes (IFCL & CFCL group). The overall survival of the transfused patients was not significantly different from that of the untransfused patients. Similarly, there was no significant difference in survival between the transfused and untransfused patients when the data concerning septicemia were analyzed. When patients showed bone-marrow recovery, which was indicated by recovery of granulocytes to 500/mm3 or more during the study, 20-day survival was observed in 13 of 14 untransfused patients and in all of 26 transfused patients. In contrast, the survival rate for the patients without bone-marrow recovery was 13% (2/15) in the control group, 39% (7/18) in the FL group and 57% (8/14) in the IFCL & CFCL group respectively. Thus, the survival rate was significantly higher for the transfused than for the untransfused patients. These observations suggest that therapeutic granulocyte transfusions may be of limited value in improving the outcome of severe infections in persistently granulocytopenic patients. Since bone-marrow recovery is a critical factor for the prognosis of severe infections, therapeutic granulocyte transfusions do not provide any beneficial effects in granulocytopenic patients whose bone-marrow function will recover.
在一项涉及75例粒细胞减少且伴有严重感染患者的对照试验中，对治疗性粒细胞输注的有效性进行了研究。粒细胞计数低于200/mm³且对抗生素治疗无反应的患者被分配接受单独抗生素治疗或粒细胞输注加抗生素治疗。粒细胞通过过滤白细胞去除术（FL）、间歇流动离心白细胞去除术（IFCL）或连续流动离心白细胞去除术（CFCL）进行采集。根据进入研究后20天的生存率评估粒细胞输注的治疗效果。患者被分为三组：1）22例患者因29次感染发作接受单独抗生素治疗（对照组）；2）27例患者因31次感染发作接受131次通过FL采集的粒细胞输注（FL组）；3）26例患者因27次感染发作接受139次通过IFCL和CFCL采集的粒细胞输注（IFCL & CFCL组）。输注粒细胞患者的总体生存率与未输注患者的总体生存率无显著差异。同样，分析败血症相关数据时，输注和未输注患者的生存率也无显著差异。当患者出现骨髓恢复时，即研究期间粒细胞恢复至500/mm³或更高，14例未输注患者中有13例以及26例输注患者全部观察到20天生存率。相比之下，对照组中无骨髓恢复患者的生存率为13%（2/15），FL组为39%（7/18），IFCL & CFCL组为57%（8/14）。因此，输注粒细胞患者的生存率显著高于未输注患者。这些观察结果表明，治疗性粒细胞输注在改善持续性粒细胞减少患者严重感染的结局方面可能价值有限。由于骨髓恢复是严重感染预后的关键因素，治疗性粒细胞输注对骨髓功能将恢复的粒细胞减少患者没有任何有益效果。
