How are granulocytes for transfusion best used? The past, the present and the future.
Abstract
Granulocyte transfusions continue to be used in clinical practice, predominantly for treatment of refractory infection in the setting of severe neutropenia. There is biological plausibility for effectiveness in these patients with deficiencies of neutrophils, either as a consequence of disease or treatment. However, there is a chequered history of conducting and completing interventional trials to define optimal use, and many uncertainties remain regarding schedule and dose. Practice and clinical studies are severely limited by the short shelf life and viability of current products, which often restricts the timely access to granulocyte transfusions. In the future, methods are needed to optimise donor-derived granulocyte products. Options include use of manufactured neutrophils, expanded and engineered from stem cells. Further possibilities include manipulation of neutrophils to enhance their function and/or longevity. Granulocyte transfusions contain a heterogeneous mix of cells, and there is additional interest in how these transfusions may have immunomodulatory effects, including for potential uses as adjuncts for anti-cancer effects.Citation
Morton S, Fleming K, Stanworth SJ. How are granulocytes for transfusion best used? The past, the present and the future. Br J Haematol. 2023 Feb;200(4):420-428. doi: 10.1111/bjh.18445. Epub 2022 Sep 17Type
ArticleAdditional Links
http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2141PMID
36114720Journal
British Journal of HaematologyPublisher
Wileyae974a485f413a2113503eed53cd6c53
10.1111/bjh.18445