Donor Granulocyte Transfusions in Febrile Neutropenic Pediatric Oncology Patients

To describe the clinical course of febrile neutropenic pediatric oncology patients undergoing granulocyte transfusions (GTF), we performed a retrospective chart review of all pediatric oncology patients with febrile neutropenia receiving granulocyte transfusions between September 2009 and September 2011 in a University Hospital setting. Thirty-seven patients received a total of 51 courses of GTFs. In 35 febrile episodes patients had leukemia and in 16 episodes patients had solid tumors. Three patients received allogeneic hematopoietic stem cell transplantation from their HLA identical sibling. Mean duration of fever and neutropenia was 18.5 +/- 17.5 days. Infections were classified as fever of unknown origin (21%, n= 11), microbiologically documented infection (44%, n= 23), clinically suspected infection (35%, n= 18). The mean granulocyte yield, WBC count and granulocyte count of the products were 3.1 +/- 1.2x(10)/unit, 158.6 +/- 66.4x10(3)/mm(3) and 134.5 +/- 62x 10(3)/mm(3), respectively. The median donor WBC count at leukapheresis was 32.91x10(3)/L. GTFs were well tolerated except one patient who had fever during transfusion. Thirty-nine (76.5%) of the episodes resolved from infection and discharged from the hospital. Of the 12 patients (23.5%) who died, seven of them were refractory to treatment, three patients had relapsed disease and two patients had newly diagnosed disease. This case series documents the course of 37 septic neutropenic pediatric oncology patients who underwent a total of 51 GTF courses. GTFs were generally well tolerated and improve short-term outcome in neutropenic pediatric oncology patients.