From the Research
Granulocytes, specifically neutrophils, are the type of white blood cells that should be sent to hospitals for transfusion. These transfusions are primarily indicated for patients with severe neutropenia (neutrophil count below 500 cells/μL) who have a documented infection not responding to appropriate antimicrobial therapy 1. The standard dose is approximately 1-2 x 10^10 granulocytes per transfusion, usually administered daily until neutrophil recovery or infection resolution. Each transfusion should be given slowly over 2-4 hours through a standard blood filter. Patients should receive premedication with acetaminophen and diphenhydramine to reduce transfusion reactions, and in some cases, corticosteroids may be added.
Key Points to Consider
- Granulocyte transfusions work by temporarily increasing neutrophil counts to help fight infections while waiting for the patient's bone marrow to recover 2.
- These transfusions are particularly beneficial for neutropenic patients with bacterial or fungal infections, especially those with prolonged neutropenia due to chemotherapy, hematopoietic stem cell transplantation, or bone marrow failure syndromes 3.
- However, their use is limited by short shelf-life (24 hours), limited availability, and potential for adverse reactions including fever, chills, and respiratory distress 4.
- The clinical efficacy of the transfusions should be evaluated daily, and the granulocyte concentrate should contain a large number of cells, which usually means that the donor should be mobilized with steroids and G-CSF 2.
Donor Considerations
- Regular blood donors as well as relatives to the patient can be used for granulocyte donations with apheresis technique after information of the process 2.
- Donors should be mobilized with G-CSF and/or steroids to increase the yield of granulocytes 3.
Future Directions
- Methods are needed to optimize donor-derived granulocyte products, including the use of manufactured neutrophils, expanded and engineered from stem cells 1.
- Further possibilities include manipulation of neutrophils to enhance their function and/or longevity, and exploration of immunomodulatory effects of granulocyte transfusions 1.