Leucocyte transfusions from rhG-CSF or prednisolone stimulated donors for treatment of severe infections in immunocompromised neutropenic patients
Leucocyte transfusions from rhG-CSF or prednisolone stimulated donors for treatment of severe infections in immunocompromised neutropenic patients
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DOI：
10.1046/j.1365-2141.1999.01619.x
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发表时间：
1999-09-01
影响因子：
6.5
通讯作者：
Gadner, H
中科院分区：
文献类型：
--
作者：
Peters, C;Minkov, M;Gadner, H
化疗后深度中性粒细胞减少的脓毒症与高死亡率相关，尽管适当的抗菌或抗真菌治疗。在一项前瞻性I/II期研究中，我们评估了白细胞输注（LT）在治疗相关骨髓发育不全期间患有严重细菌或真菌感染的恶性肿瘤或血液系统疾病患者中的可行性和有效性。30例有严重中性粒细胞减少症和危及生命的败血症临床症状的患者接受了rhg - csf刺激的家庭供体或泼尼松龙引发的志愿者的肾移植治疗。共给药301例。每位患者LT的中位数为7（范围3 - 65），LT治疗的中位数持续时间为8天（范围2-35），ehG-CSF刺激供者的白细胞计数（WBC），绝对中性粒细胞计数（ANC）和淋巴细胞计数显著高于泼尼松龙诱导的志愿者（P=0.0001）。尽管患者病情危重，但LT通常耐受性良好。仅有39例（12.9%）LT伴有不良反应。通过从rhG-CSF和泼尼松龙刺激的供体中采集的白细胞的连续流式白细胞采血，导致我们的患者外周血白细胞和ANC计数的可测量的增加。在第一次肝移植后的第100天，20/30的患者存活并完全清除了感染。
Sepsis in profound neutropenia after chemotherapy is associated with high mortality despite appropriate antibacterial or antifungal treatment. In a prospective phase I/II study we evaluated the feasability and efficacy of leucocyte transfusions (LT) in patients with malignancies or haematological disorders who were suffering from severe bacterial or fungal infection during therapy-related bone marrow aplasia. 30 patients with severe neutropenia and clinical signs of life-threatening sepsis not responding to adequate treatment, received LT from rhG-CSF-stimulated family donors or from prednisolone-primed volunteers. A total of 301 LT were administered. The median number of LT per patient was seven (range three to 65), the median duration of LT treatment was 8 d (range 2-35), The white cell count (WBC), absolute neutrophil count (ANC) and lymphocyte count of the concerntrates from ehG-CSF- stimulated donors were sinificantly higher than those from prednisolone-primed volunteers (P=0.0001). Despite the critical condition of the patients, LT were generally well tolerated. Only 39 (12.9%) LT were associated with adverse reactions. The transfusion of leucocytes collected by continuous flow leukapheresis from both rhG-CSF and prednisolone stimulated donors resulted in a measurable increment of the peripheral leucocyte and ANC counts in our patients. On day 100 after the first LT, 20/30 patients were alive with complete clearance of the infection.