Korean J Hematol 1999; 34(2):

Published online June 30, 1999

© The Korean Society of Hematology

호중구감소증과 연관된 감염의 치료로서 과립구 수혈 치료의 효과

이제중, 정익주, 김형준, 박무림, 신동현, 변정래, 권상용, 양덕환, 김찬종, 국훈, 황태주, 김종필, 양동욱

전남대학교 의과대학 내과학교실,
전남대학교 의과대학 소아과학교실,
전남대학교 의과대학 임상병리학교실

Clinical Effect of Granulocyte Transfusion Therapy in Neutropenia-Related Infection

Je Jung Lee, Ik Joo Chung, Hyeoung Joon Kim, Moo Rim Park, Dong Hyeon Shin, Jeong Rae Byun, Sang Yong Kwon, Duc Hwan Yang, Chan Jong Kim, Hoon Kook, Tai Ju Hwang, Jong Phil Kim, Dong Wook Ryang

Department of Internal Medicine, Pediatrics, Clinical Pathology, Chonnam University Medical School, Kwangju, Korea

Abstract

Background: After a zealous advocates of granulocyte transfusion therapy (GTX) in the 1970s and early 1980s, the use of GTX has diminished strikingly because of the several problems of GTX and the introduction of new antimicrobial agents and recombinant hematopoietic growth factors. Recently, GTX offers renewed interest because several investigators reported the trans-granulocyte-colony stimulating factor(G-CSF).
Method: To evaluate the safety and efficacy of GTX, thirteen patients with neutropenia-related infections at Chonnam University Hospital from March 1997 to February 1998 were treated with dexamethasone or G-CSF-stimulated granulocyte transfusions apheresed from normal donor.
Result: Patients received a mean number of 2.4 transfusions (range,1-7)and a mean dose of 5.5×1010 granulocytes (range, 0.2-19.6). Six patients (46.2%) had favorable responses. Favorable responses occurred among patients with more fungal infection than vacterial infection (71.4 vs 28.6%, P<0.05) and more increment of absolute neutrophil count at 1 hour after (P<0.05). Adverse reactions of GTX were pulmonary edema in 2 patient (15.4%) and transient hypoxia in 1 patient(7.7%). One patient(7.7%) with pulmonary edema died of severe pulmonary reaction. Two of 20 donors received by G-CSF complaind of mild myalgia and bone pain.
Conclusion: G-CSF or dexamethasone-stimulated GTXs were well tolerated and may be clinically beneficial for neutropenia-related infection, particulary in fungal infection, that is refractory to antimicrobial therapy.

Keywords Granulocyte transfusion therapy, Neutropenia, Infection, G-CSF

Article

Korean J Hematol 1999; 34(2): 326-333

Published online June 30, 1999

Copyright © The Korean Society of Hematology.

호중구감소증과 연관된 감염의 치료로서 과립구 수혈 치료의 효과

이제중, 정익주, 김형준, 박무림, 신동현, 변정래, 권상용, 양덕환, 김찬종, 국훈, 황태주, 김종필, 양동욱

전남대학교 의과대학 내과학교실,
전남대학교 의과대학 소아과학교실,
전남대학교 의과대학 임상병리학교실

Clinical Effect of Granulocyte Transfusion Therapy in Neutropenia-Related Infection

Je Jung Lee, Ik Joo Chung, Hyeoung Joon Kim, Moo Rim Park, Dong Hyeon Shin, Jeong Rae Byun, Sang Yong Kwon, Duc Hwan Yang, Chan Jong Kim, Hoon Kook, Tai Ju Hwang, Jong Phil Kim, Dong Wook Ryang

Department of Internal Medicine, Pediatrics, Clinical Pathology, Chonnam University Medical School, Kwangju, Korea

Abstract

Background: After a zealous advocates of granulocyte transfusion therapy (GTX) in the 1970s and early 1980s, the use of GTX has diminished strikingly because of the several problems of GTX and the introduction of new antimicrobial agents and recombinant hematopoietic growth factors. Recently, GTX offers renewed interest because several investigators reported the trans-granulocyte-colony stimulating factor(G-CSF).
Method: To evaluate the safety and efficacy of GTX, thirteen patients with neutropenia-related infections at Chonnam University Hospital from March 1997 to February 1998 were treated with dexamethasone or G-CSF-stimulated granulocyte transfusions apheresed from normal donor.
Result: Patients received a mean number of 2.4 transfusions (range,1-7)and a mean dose of 5.5×1010 granulocytes (range, 0.2-19.6). Six patients (46.2%) had favorable responses. Favorable responses occurred among patients with more fungal infection than vacterial infection (71.4 vs 28.6%, P<0.05) and more increment of absolute neutrophil count at 1 hour after (P<0.05). Adverse reactions of GTX were pulmonary edema in 2 patient (15.4%) and transient hypoxia in 1 patient(7.7%). One patient(7.7%) with pulmonary edema died of severe pulmonary reaction. Two of 20 donors received by G-CSF complaind of mild myalgia and bone pain.
Conclusion: G-CSF or dexamethasone-stimulated GTXs were well tolerated and may be clinically beneficial for neutropenia-related infection, particulary in fungal infection, that is refractory to antimicrobial therapy.

Keywords: Granulocyte transfusion therapy, Neutropenia, Infection, G-CSF

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