The effect of granulocyte transfusion on engraftment in patients with allogeneic hematopoietic stem cell transplantation

Abstract

Aim: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is still one of the most effective treatments for many hematological malignancies. However, especially infections and neutropenic fever increase mortality during the engraftment development process after allo-HSCT. This study investigated the effect and safety profile of granulocyte transfusion (GT) on engraftment in patients with neutropenic fever after allo-HSCT.
 Material and Method: We investigated 32 patients with hematological malignancies who had neutropenic fever following allo-HSCT between June 2018 and February 2020. Seventeen patients were given GT and defined as GT group (GTG). GT was given once daily until improvement in clinical and laboratory parameters (neutrophil >0.5 ×10³/µL, platelet >20 ×10³/µL). Fifteen patients who did not receive GT were included as a control group (CG).
 Results: By comparing leukocyte levels between the start and end of GT, the median leukocyte increase was shown as 1.93 (0.37- 10.21) ×10³/µL (p=0.001). Similarly, the median neutrophil increase was 1.14 (0.25-9.24) ×10³/µL (p=0.001). A total of 65 GTs were administered, the average number of days was 4±1. The average dose of infused granulocyte was 4 ×1010/unit. In GTG, neutrophil and platelet engraftments occurred on average at 14±2 and 10±2 days, respectively. In CG, neutrophil and platelet engraftments occurred on average 15±2 and 12±3 days, respectively. There was no statistically significant difference in neutrophil and platelet engraftment between the two groups (p=0.4, p=0.06, respectively).
 Conclusion: GT was observed to be effective in managing complications such as neutropenic fever and sepsis after allo-HSCT by shortening the duration of neutropenia and increasing neutrophil and leukocyte values. Although statistical significance was not observed in our study, it was observed that the engraftment times were shortened with GT.