[Kinetic and organization of granulocytes transfusion: a case report]

Transfus Clin Biol. 2014 Dec;21(6):324-7. doi: 10.1016/j.tracli.2014.09.005. Epub 2014 Nov 6.
[Article in French]

Abstract

Background: Therapeutic granulocyte transfusion remains an indication for neutropenic sepsis associated with prolonged neutropenia. However, harvest complexity and lack of proved efficacy mark the limits of its development.

Case report: A 58-year old man received allogeneic stem cell transplantation for osteomyelofibrosis. Six months later, after a transplant rejection, he presented with perineal cellulitis from hemorrhoid origin, without any microbiological documentation. The evolution was unfavorable despite antibiotic and antifungal therapy. A set of seven granulocytes transfusions was initiated. Re-circulation of granulocytes analysis showed an initial increase (H2) followed by a decrease (H8) reaching the basal rate at H16. No toxicity has been reported during or following the transfusions. Clinical improvement has been reported five days after the first transfusion, scaring over at D15, without any neutrophil recovery.

Conclusion: In 2014, granulocyte transfusion therapy is indicated for severe infection associated with long-term neutropenia. Minimal circulation of transfused cells in our observation and fast clinical improvement suggest the concentration of granulocytes on the infected area.

Keywords: Granulocytes transfusion; Osteomyelofibrosis; Ostéomyélofibrose; Transfusion granulocytes.

Publication types

  • Case Reports

MeSH terms

  • Allografts
  • Anti-Infective Agents / therapeutic use
  • Cellulitis / drug therapy
  • Cellulitis / etiology
  • Cellulitis / therapy
  • Combined Modality Therapy
  • Graft Rejection / drug therapy
  • Granulocytes / transplantation*
  • Hematopoietic Stem Cell Transplantation
  • Hemorrhoids / complications
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Leukocyte Transfusion*
  • Male
  • Middle Aged
  • Neutropenia / etiology
  • Neutropenia / therapy*
  • Nitriles
  • Primary Myelofibrosis / therapy
  • Pseudomonas Infections / drug therapy
  • Pseudomonas Infections / etiology
  • Pseudomonas Infections / therapy
  • Pyrazoles / adverse effects
  • Pyrazoles / therapeutic use
  • Pyrimidines
  • Shock, Septic / etiology
  • Splenectomy / adverse effects

Substances

  • Anti-Infective Agents
  • Immunosuppressive Agents
  • Nitriles
  • Pyrazoles
  • Pyrimidines
  • ruxolitinib