Granulocyte transfusion therapy in chronic granulomatous disease. Report of a patient and review of the literature.

Abstract

A l6-year-old boy with chronic granulomatous disease (CGD) and multiple Staphylococcus aureus hepatic abscesses failed to respond to intense antimicrobial therapy and surgical drainage procedures. He was started on a l3-day course of daily granulocyte transfusions obtained by intermittent-flow leukapheresis (haemonetics Model 30 [Braintree, Massachusetts]) utilizing hydroxyethyl starch. Each transfusion contained an average of 9 X l0(9) granulocytes. He defervesced on the seventh transfusion day, and the sedimentation rate returned to normal on the thirteenth transfusion day. Radionuclide scan showed decrease in size of the liver abscesses. No other new therapeutic modalities were attempted during the period of granulocyte transfusion. Although the use of granulocyte transfusion has been suggested to treat infections in CGD, we report the first successful use of granulocyte transfusion therapy in S. aureus abscess disease in CGD. Granulocyte transfusions may be helpful in treating infections refractory to standard medical-surgical management in patients with CGD and other disorders of neutrophil function.