Donor Granulocyte Transfusions in Patients with Hematologic Malignancies and in Recipients of Hematopoietic Stem Cell Transplantation

Despite the progress achieved in antimicrobial therapies and supportive care, infections remain a major cause of morbidity and mortality in patients with hematologic malignancies and in recipients of hematopoietic stem cell transplantation. In the 1990s, there was renewed interest in donor granulocyte transfusions due to the availability of granulocyte-colony stimulating factor and advanced apheresis technology. The results of several clinical trials did not show clear advantage of adding granolucyte concentrates to antimicrobial therapies due to significant defects that affected the final results of these trials. With the recent increase in incidence of multidrug resistant bacteria and invasive fungal infections in neutropenic patients and the reduced efficacy of the recently introduced antimicrobial agents, the need for transfusing donor granulocytes to these patients is renewed again. However, well designed, multicenter randomized controlled trials that include large numbers of patients are needed to determine the effectiveness of donor granulocyte transfusions in these severely immunocompromised patients.