Concomitant administration of granulocyte transfusions and amphotericin B
in neutropenic patients: absence of significant pulmonary toxicity
BW Dana, BG Durie, RF White and DW Huestis
One hundred and ninety-five series of granulocyte transfusions in 144
patients were evaluated with respect to possible severe pulmonary toxicity
from concomitant administration of granulocytes and amphotericin B. Dyspnea
as a side effect of granulocyte transfusion was equally common among
patients receiving amphotericin B and those in a matched control group not
receiving amphotericin B. Granulocyte transfusions and amphotericin B were
given simultaneously in 35 transfusion series, involving 32 patients.
Respiratory deterioration, defined as the appearance of new pulmonary
infiltrates on chest x-ray, occurred in 11 of these 35 episodes. Patients
developing respiratory deterioration were similar to those not developing
respiratory deterioration in age, diagnosis, disease status, duration of
concomitant therapy, and outcome, but more often had positive fungal
cultures as an indication for treatment (91% versus 58%; p = 0.1). In 8
patients, the episodes of respiratory deterioration were readily explained
by congestive heart failure, by simultaneous bacteremia or fungemia, or by
fungal pneumonia discovered at autopsy. One patient had a leukoagglutinin
reaction (responsive to steroids) and the other 2 had unexplained, but
reversible respiratory deterioration. We concluded that concomitant
administration of granulocyte transfusions and amphotericin B is not
associated with unexpected or rapidly fatal pulmonary toxicity and when
appropriate, can be safely accomplished.
Volume 57,
Issue 1,
pp. 90-94,
01/01/1981
Copyright © 1981 by The American Society of Hematology
