Diagnosis:
Granulocyte indications
• Granulocyte transfusions have been reported to be successful in the treatment of bacterial and fungal infections in severely neutropenic patients who are unresponsive to antibiotic or antifungal therapy.
• Granulocyte transfusions should only be considered in patients with temporary severe neutropenia and bone marrow recovery is expected.
• The absolute neutrophil count of recipients should be less than 500/μL.
• Patients with chronic granulomatous disease and deep-seated abscesses or fungal infections unresponsive to antibiotic/antifungal therapy are also considered candidates for granulocyte transfusion therapy.
• Granulocyte transfusions are given once daily until the patient recovers.
• Granulocyte transfusions should be ABO-compatible and irradiated.
• Granulocytes should be cytomegalovirus (CMV) negative when provided to CMV-negative patients.
• Granulocyte transfusions and amphotericin administration should be spaced out temporally due to the increase in respiratory reactions.
• Doses less than 1 × 1010 cells/kg are generally ineffective.
• Donors are stimulated with corticosteroids with or without costimulation with granulocyte-colony stimulating factor (G-CSF) to achieve higher yields.
