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Blood, Vol. 95 No. 11 (June 1), 2000:
pp. 3302-3309
Phase I/II trial of neutrophil transfusions from donors stimulated
with G-CSF and dexamethasone for treatment of patients with
infections in hematopoietic stem cell transplantation
Thomas H. Price,
Raleigh A. Bowden,
Michael Boeckh,
Juergen Bux,
Karen Nelson,
W. Conrad Liles, and
David C. Dale
From the Department of Medicine, University of Washington, Puget
Sound Blood Center, Seattle, WA; Fred Hutchinson Cancer Research
Center, Seattle, WA; and Justus-Leibig University, Giessen, Germany.
We examined the feasibility of a community blood bank granulocyte
transfusion program utilizing community donors stimulated with a
single-dose regimen of subcutaneous granulocyte
colony-stimulating factor (G-CSF) plus oral dexamethasone. The
recipients of these transfusions were neutropenic stem cell
transplantation patients with severe bacterial or fungal infection.
Nineteen patients received 165 transfusions (mean 8.6 transfusions/patient, range 1-25). Community donors provided 94% of
the transfusions; relatives accounted for only 6% of the transfusions.
Sixty percent of the community donors initially contacted agreed to
participate, and 98% of these individuals indicated willingness to
participate again. Transfusion of 81.9 ±
2.3 × 109 neutrophils (mean ± SD)
resulted in a mean 1-hour posttransfusion neutrophil increment of
2.6 ± 2.6 × 103/µL and restored the peripheral
neutrophil count to the normal range in 17 of the 19 patients. The
buccal neutrophil response, a measure of the capacity of neutrophils to
migrate to tissue sites in vivo, was restored to normal in most
patients following the transfusion. Chills, fever, and arterial oxygen
desaturation of  3% occurred in 7% of the transfusions, but these
changes were not sufficient to limit therapy. Infection resolved in 8 of 11 patients with invasive bacterial infections or candidemia. These
studies indicate that transfusion of neutrophils from donors stimulated
with G-CSF plus dexamethasone can restore a severely neutropenic
patient's blood neutrophil supply and neutrophil inflammation response. Further studies are needed to evaluate the clinical efficacy
of this therapy.
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