Differences in the product characteristics and clinical use of granulocytes for transfusion: the BEST Collaborative study
Cain, Lorna Lafrance, Charles Morton, Suzy Latour, Catherine Girard, Mélissa Tiberghien, Pierre de la Taille, Virginie Datta, Suvro Sankha Virk, Mrigender Singh Andrews, Jennifer
Cain, Lorna
Lafrance, Charles
Morton, Suzy
Latour, Catherine
Girard, Mélissa
Tiberghien, Pierre
de la Taille, Virginie
Datta, Suvro Sankha
Virk, Mrigender Singh
Andrews, Jennifer
Affiliation
NHS Blood and Transplant; Oxford University Hospitals NHS Trust; University of Oxford; Héma-Québec; CISSS de Chaudière-Appalaches; Laval University; University Hospitals Birmingham NHS Foundation Trust; Établissement Français du Sang; Université de Franche-Comté; Tata Medical Center; Stanford University Medical Center; Vanderbilt University Medical Center; Rabin Medical Center; Tel Aviv University; Hospital Nacional de Pediatría SAMIC Prof. Dr. Juan P. Garrahan; New Zealand Blood Service; Hospital Israelita Albert Einstein; Banc de Sang i Teixits; Australian Red Cross Lifeblood; German Red Cross Blood Service NSTOB; University Medicine Oldenburg; Unit Transfusion Medicine Sanquin; Erasmus University Medical Center; Erasmus MC-Sophia Children's Hospital; Seattle Children's Hospital; University of Washington
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Publication date
2025-05-15
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Abstract
Background: Whether granulocytes for transfusion are beneficial remains uncertain, although some evidence suggests that efficacy may be dose-related. Granulocytes are mostly produced by apheresis procedure, but other means of production are increasingly used.
Methods: Centers that produce and/or use granulocytes were recruited through the BEST Collaborative and completed a detailed survey of granulocyte manufacture, specifications, clinical use, operational considerations, and data collection initiatives.
Results: Fifteen national, regional, and local producers and/or users of granulocytes were included. Granulocytes were produced from apheresis procedure (n = 10), pooled buffy coats (n = 2), single buffy coats (n = 4) or pooling of residual leukocyte units from whole blood processing (n = 1). The mean adult dose of granulocytes reported was 1.6 to 3.7 × 1010 for apheresis, and 1.8 to 2.2 × 1010 for pooled buffy coat granulocytes. For apheresis procedure donations, donor stimulation included steroids and/or granulocyte colony-stimulating factor. Centers providing whole blood-derived granulocytes reported shorter times from request to delivery than those using apheresis procedure products. Indications and product selection criteria were similar. The most frequently reported challenges with granulocytes were donor availability for apheresis procedure (n = 7), short shelf life (n = 5) and lack of evidence of efficacy (n = 5). The cost of one unit of apheresis procedure granulocytes ranged from 568 to 7500 PPP-USD, and for one pooled buffy coat unit was from 2208 to 2822 PPP-USD.
Conclusions: We have highlighted differences in granulocyte production that are relevant for the design and interpretation of much needed international clinical studies.
Citation
Cain L, Lafrance C, Morton S, Latour C, Girard M, Tiberghien P, de la Taille V, Datta SS, Virk MS, Andrews J, Yahalom V, Pugliese AM, Alba R, Charlewood R, Kirwan S, Yokoyama APH, Kutner JM, Nogues EA, Martinez I Llonch N, Daly J, Irving DO, Schulze TJ, Huisman E, Le Poole K, Vrielink H, Saifee NH, Pagano MB, Stanworth S; Biomedical Excellence for Safer Transfusion Collaborative. Differences in the product characteristics and clinical use of granulocytes for transfusion: The BEST Collaborative study. Transfusion. 2025 Jun;65(6):1111-1123. doi: 10.1111/trf.18263. Epub 2025 May 15.
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Article