Granulocyte Transfusion Therapy

  • Donald J. Higby
Part of the Cancer Treatment and Research book series (CTAR, volume 13)


There is much controversy surrounding granulocyte transfusion therapy today. Questions about the clinical utility of granulocyte transfusions once thought to be settled are now rightly being raised again. A historical perspective is useful as a first step towards addressing this issue.


Acute Leukemia Neutropenic Patient Buffy Coat Hydroxyethyl Starch Granulocyte Transfusion 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Han T, Stutzman L, Cohen E: Effects of platelet transfusions on hemorrhage in patients with acute leukemia. Cancer 19: 1937–42, 1966.PubMedCrossRefGoogle Scholar
  2. 2.
    Higby DJ, Cohen E, Holland JF: The prophylactic treatment of thrombocytopenic leukemia patients with platelets: a double blind study. Transfusion 14 (5): 440–446, 1974.PubMedCrossRefGoogle Scholar
  3. 3.
    Tattersall M, Spiers AS, Darrel JH: Initial therapy with combination of five antibiotics in febrile patients with leukemia and neutropenia. Lancet, January 22, 1972, pp 162–165.Google Scholar
  4. 4.
    Preisler HD, Goldstein IM, Henderson ES: Gastrointestinal sterilization in the treatment of patients with acute leukemia. Cancer 26: 1076–1081, 1970.PubMedCrossRefGoogle Scholar
  5. 5.
    Bodey GP, Gehan EA, Freireich EJ: Protected environment-prophylactic antibiotic program in the chemotherapy of acute leukemia. Am J Med Sci 262: 138–151, 1971.PubMedCrossRefGoogle Scholar
  6. 6.
    Levine AS, Siegel SE, Schreiber AD: Protected environment and prophylactic antibiotics: a prospective controlled study of their utility in the therapy of acute leukemia. New Engl J Med 288: 477–483, 1973.PubMedCrossRefGoogle Scholar
  7. 7.
    Schimpff SC, Greene WH, Young VM: Infection prevention in acute non-lymphocytic leukemia. Ann Intern Med 82: 351–358, 1975.PubMedGoogle Scholar
  8. 8.
    Yates JW, Holland JF: A controlled study of isolation and endogenous microbial suppression in acute myelocytic leukemia patients. Cancer 32: 1490–1498, 1973.PubMedCrossRefGoogle Scholar
  9. 9.
    Bodey GP, Buckley M, Sathe YS: Quantitative relationships between circulating leukocytes and infection in patients with acute leukemia. Ann Intern Med 64: 328–336, 1966.PubMedGoogle Scholar
  10. 10.
    Freireich EJ, Levin RH, Carbone PP: The function and fate of transfused granulocytes from donors with chronic myelocytic leukemia in leukopenic recipients. Ann NY Acad Sci 113: 1081, 1965.CrossRefGoogle Scholar
  11. 11.
    Bussel A, Benbunan M, Grange MJ, Boiron M, Bernard J: Comparison of clinical results induced by irradiated and non-irradiated chronic myelocytic leukemia cell transfusions and the relationship to in vitro studies. In: Leukocytes: Separation, Collection and Transfusion, Goldman JM, Lowenthal RM (eds). London, Academic Press, 1975, pp 395–401.Google Scholar
  12. 12.
    Freireich EJ, Judson G, Levin RH: Separation and collection of leukocytes. Cancer Res 25: 1511–1514, 1965.PubMedGoogle Scholar
  13. 13.
    Djerassi I, Kim JS, Mitrakul C, Suvansri U, Ciesielka W: Filtration leukapheresis for separation and concentration of transfusable amounts of normal human granulocytes. J Med (Basel) 1: 358–362, 1970.Google Scholar
  14. 14.
    Mishler JM: Hydroxyethyl starch as an experimental adjunct to leukocyte separation by centrifugal means: review of safety and efficacy. Transfusion 15: 449–460, 1975.PubMedCrossRefGoogle Scholar
  15. 15.
    Mishler JM: The effects of corticosteroids on mobilization and function of neutrophils. Exp Hematol 5 (Suppl 1): 15–32, 1977.Google Scholar
  16. 16.
    Nusbacher J, MacPherson JL, Manejias RE, Bennett JM: Leukapheresis: The effect of a single high oral dose of prednisone on granulocyte mobilization, yield and function. Transfusion 13: 366, 1973.Google Scholar
  17. 17.
    Mishler JM, Higby DJ, Rhomberg W, Cohen E, Nicora RW, Holland JF: Hydroxyethyl starch and dexamethasone as an adjunct to leukocyte separation with the IBM blood cell separator. Transfusion 14: 352–356, 1974.PubMedCrossRefGoogle Scholar
  18. 18.
    Higby DJ, Salvatori V, Burnett D, Park BH: Improving the quality of granulocytes obtained by filtration leukapheresis. Exp Hematol 7 (Suppl 4): 36–41, 1979.PubMedGoogle Scholar
  19. 19.
    Wright DG, Klock JC: Functional changes in neutrophils collected by filtration leukapheresis and their relationship to cellular events that occur during adherence of neutrophils to nylon fibers. Exp Hematol 7 (Suppl 4): 11–23, 1979.PubMedGoogle Scholar
  20. 20.
    Nusbacher J, Rosenfeld SI, Leddy J, Kelmperer M, MacPherson JL: The leukokinetic changes and complement activation associated with filtration leukapheresis. Exp Hematol 7 (Suppl 4): 31–35, 1979.Google Scholar
  21. 21.
    Duhlke MB, Shah SL, Sherwood WC et al.: Priaprism during filtration leukapheresis. Transfusion 19: 482–487, 1979.CrossRefGoogle Scholar
  22. 22.
    Wiltbank TB, Nusbacher J, Higby DJ, MacPherson JL: Abdominal pain in donors during filtration leukapheresis. Transfusion 17: 159–162, 1977.PubMedCrossRefGoogle Scholar
  23. 23.
    Wright DG, Kauffman JC, Chusid MJ, Herzig GP, Gallin JI: Functional abnormalities of human neutrophils collected by continuous flow filtration leukapheresis. Blood 46: 901–911, 1975.PubMedGoogle Scholar
  24. 24.
    Higby DJ, Henderson ES, Burnett D, Cohen E: Filtration leukapheresis: effects of donor stimulation with dexamethsone. Blood 50: 953–959, 1977PubMedGoogle Scholar
  25. 25.
    Djerassi I: Gravity leukapheresis - a new method for collection of transfusable granulocytes. Exp Hematol 5 (Suppl 1): 139–143, 1977.Google Scholar
  26. 26.
    Boggs DR: The kinetics of neutrophilic leukocytes in health and disease. Seminars in Hematology 4: 359–386, 1967.PubMedGoogle Scholar
  27. 27.
    Craddock CG, Perry S, Lawrence JS: The dynamics of leukopenia and leukocytosis. Ann Intern Med 52: 281–293, 1960.PubMedGoogle Scholar
  28. 28.
    Higby DJ: Controlled prospective studies of granulocyte transfusion therapy. Exp Hematol 5 (Suppl 1): 57–64, 1977.Google Scholar
  29. 29.
    Strauss RG: Therapeutic neutrophil transfusions: Are controlled studies no longer appropriate? Am J Med 65: 1001–1005, 1978.PubMedCrossRefGoogle Scholar
  30. 30.
    Fortuny IE, Bloomfield CD, Hadlock DC, Goldman A, Kennedy BJ, McCullough JJ: Granulocyte transfusion: a controlled study in patients with acute non-lymphocytic leukemia. Transfusion 15: 548–558, 1975.PubMedCrossRefGoogle Scholar
  31. 31.
    Winston DJ, Ho WG, Gale RP: Therapeutic granulocyte transfusions for documented infections: a controlled trial in ninety-five infectious granulocytopenic episodes. Ann Intern Med (in press).Google Scholar
  32. 32.
    Lowenthal RM, Grossman L, Goldman JM, Stoning RA, Buskard NA, Park DS, Murphy BC Galton DAG: Granulocyte transfusion therapy: a comparison of the use of cells obtained from normal donors with those from patients with chronic granulocytic leukemia. In: Leukocytes: Separation, Collection, and Transfusion, Goldman JM, Lowenthal RM (eds). London, Academic Press, 1975, pp 363–379.Google Scholar
  33. 33.
    McCullough J, Weiblen J, Deinard AR, Boen J, Fortuny IE, Quie PG: In vitro function and post-transfusion survival of granulocytes collected by continuous flow centrifugation and by filtration leukapheresis. Blood 48: 315–325, 1976.PubMedGoogle Scholar
  34. 34.
    Price T, Dale D: Neutrophil preservation: The effect of short-term storage on in vitro kinetics. J Clin Invest 59: 475–481, 1977.PubMedCrossRefGoogle Scholar
  35. 35.
    McCullough J, Weiblen BJ, Peterson PK, Quie PG: Effects of temperature on granulocyte preservation. Blood 52: 301–310, 1978.PubMedGoogle Scholar
  36. 36.
    Higby DJ, Freeman AI, Henderson ES, Sinks L, Cohen E: Granulocyte transfusions in children using filter-collected cells. Cancer 38: 1407–1413, 1976.PubMedCrossRefGoogle Scholar
  37. 37.
    Christensen G, Bisno AL, Parisi JT, McLaughlin B, Hester M, Luther RW: Nosocomial septicemia due to multiply antibiotic resistant Staphylococcus epidermis. Ann Intern Med 96: 1–10, 1982.PubMedGoogle Scholar
  38. 38.
    Ford JM, Cullen MH: Prophylactic granulocyte transfusions. Exp Hematol 5 (Suppl 1): 65–72, 1977.Google Scholar
  39. 39.
    Schiffer CA, Aisner J, Daly PA, Schimpff SC, Wiernik PH: Alloimmunization following prophylactic granulocyte transfusion. Blood 54: 766–774, 1979.PubMedGoogle Scholar
  40. 40.
    Winston DJ, Ho WG, Young LS, Gale RP: Prophylactic granulocyte transfusions during human bone marrow transplantation. Am J Med 68: 893–897, 1980.PubMedCrossRefGoogle Scholar
  41. 41.
    Winston DJ, Ho WG, Gale RP: Prophylactic granulocyte transfusions during chemotherapy of acute non-lymphocytic leukemia. Ann Intern Med 94: 616–622, 1981.PubMedGoogle Scholar
  42. 42.
    Strauss RG, Connett JE, Gale RP, Bloomfield CD, Herzig GP, McCullough J, Maguire LC, Winston DJ, Ho WG, Stump DC, Miller WV, Koepke JA: A controlled trial of prophylactic granulocyte transfusions during initial induction chemotherapy for acute myelogenous leukemia. New Engl J Med 305 (11): 597–602, 1981.PubMedCrossRefGoogle Scholar
  43. 43.
    Clift RA, Sanders JE, Thomas ED, Williams B, Buckner CD: Granulocyte transfusions for the prevention of infection in patients receiving bone marrow transplants. New Engl J Med 298: 1052–1057, 1978.PubMedCrossRefGoogle Scholar
  44. 44.
    McCredie KB, Hester JP: White blood cell transfusions in the management of infection in neutropenic patients. Clinics in Hematology 5: 379–394, 1976.Google Scholar
  45. 45.
    McCredie KB, Hester JP, Freireich EJ: Leukocyte collection and transfusion physiology. Exp Hematol 5 (Suppl 1): 33–38, 1977.Google Scholar
  46. 46.
    Graw RG, Herzig G, Perry S, Henderson ES: Normal granulocyte transfusion therapy: treatment of septicemia due to gram-negative bacteria. New Engl J Med 287: 367–371, 1972.PubMedCrossRefGoogle Scholar
  47. 47.
    Herzig R, Herzig G, Graw RG, Bull MI, Ray KK: Efficacy of granulocyte transfusion therapy for gram-negative sepsis: a prospective randomized controlled study. New Engl J Med 296: 701–705, 1977.PubMedCrossRefGoogle Scholar
  48. 48.
    Vogler WR, Winton EF: The efficacy of granulocyte transfusions in neutropenic patients. Am J Med 63: 548–555, 1977.PubMedCrossRefGoogle Scholar
  49. 49.
    Higby DJ, Yates J, Henderson ES, Holland JF: Filtration leukapheresis for granulocyte transfusion therapy. New Engl J Med 292: 761–766, 1975.PubMedCrossRefGoogle Scholar
  50. 50.
    Alavi JB, Root RK, Djerasso I, Evans AE, Gluckman S, MacGregor RR, Guerry D, Schreiber AD, Shaw JM, Koch P, Cooper RA: Leukocyte transfusions in acute leukemia. New Engl J Med 296: 706–711, 1977.PubMedCrossRefGoogle Scholar
  51. 51.
    Schiffer C, Buchholz DH, Aisner A, Sanel F, Wiernik PA: Clinical experience with transfusion of granulocytes obtained by continuous flow filtration leukapheresis. Am J Med 58: 373–381, 1975.PubMedCrossRefGoogle Scholar
  52. 52.
    Buchholz DH, Houx JL: A survey of the current use of filtration leukapheresis. Exp Hematol 7 (Suppl 4): 1–10, 1979.PubMedGoogle Scholar
  53. 53.
    Ungerleider RS, Appelbaum FR, Trapani RJ, Diesseroth AB: Lack of predictive value of antileukocyte antibody screening in granulocyte transfusion therapy. Transfusion 19: 90–94, 1979.PubMedCrossRefGoogle Scholar
  54. 54.
    Appelbaum FR, Trapani RJ, Graw RG: Consequences of prior alloimmunization during granulocyte transfusion. Transfusion 17: 460–464, 1977.PubMedCrossRefGoogle Scholar
  55. 55.
    Westrick MA, Debelak-Fehir KM, Epstein RB: The effect of prior whole blood transfusion on subsequent granulocyte support in leukopenic dogs. Transfusion 17: 611–614, 1977.PubMedCrossRefGoogle Scholar
  56. 56.
    Wright DG, Robichaud KJ, Pizzo PA, Diesseroth AB: Lethal pulmonary reactions associated with the combined use of amphotericin B and leukocyte transfusions. New Engl J Med 304: 1185–1192, 1981.PubMedCrossRefGoogle Scholar
  57. 57.
    Boxer LA, Ingraham LM, Allen J, Oseas RS, Baehner RL: Amphotericin B promotes leukocyte aggregation of nylon wool fiber treated polymorphonuclear leukocytes. Blood 58: 518–523, 1981.PubMedGoogle Scholar
  58. 58.
    Dana BW, Durie BGM, White RF, Huestis DW: Concomitant administration of granulocyte transfusions and amphotericin B in neutropenic patients: absence of significant pulmonary toxicity. Blood 57: 91–96, 1981.Google Scholar
  59. 59.
    Winston DJ, Ho WG, Howell CL, Miller MJ, Mickey R, Martin WJ, Lin Cheng-Hsien, Gale RP: Cytomegalovirus infections associated with leukocyte transfusion. Ann Intern Med 93: 671–675, 1980.PubMedGoogle Scholar
  60. 60.
    Von Fliedner V, Higby DJ, Kim U: Graft vs host disease following blood product transfusion: case report and review of the literature. Am J Med (in press).Google Scholar
  61. 61.
    Epstein RB, Waxman FJ, Bennett BT, Anderson BR: Pseudomonas septicemia in neutropenic dogs. I. Treatment with granulocyte transfusions. Transfusion 14: 51–57, 1974.PubMedCrossRefGoogle Scholar
  62. 62.
    EORTC International Antimicrobial Therapy Project Group: Three antibiotic regimens in the treatment of infection in febrile granulocytopenic patients with cancer. J Infect Dis 137 (1): 14–29, 1978.CrossRefGoogle Scholar
  63. 63.
    Van Furth R: Origin and kinetics of monocytes and macrophages. Seminars in Hematology 7: 125–141, 1970.PubMedGoogle Scholar
  64. 64.
    Jacob HS: Granulocyte-complement interaction. Arch Intern Med 138: 461–463, 1978.PubMedCrossRefGoogle Scholar
  65. 65.
    Thakur ML, Lavender JP, Arnot RN, Silvester DJ, Segal AW: Indium-Ill labelled autologous leukocytes in man. J Nucl Med 18: 1014–1021, 1977.PubMedGoogle Scholar

Copyright information

© Martinus Nijhoff Publishers, Boston 1983

Authors and Affiliations

  • Donald J. Higby

There are no affiliations available

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