Revisiting the use of granulocyte transfusions in pediatric oncology patients

To describe the clinical course of neutropenic pediatric oncology patients undergoing granulocyte transfusions (GTF). Retrospective chart review including all children receiving GTFs between March, 1998 and June, 2000. Tertiary Children's Hospital and Regional Medical Center. Thirteen pediatric oncology patients (age, 9 mo to 16 y) with neutropenia and proven or suspected serious infection. These 13 patients received a total of 14 courses of GTFs (number of transfusions per course ranged from 1 to 43, median=4.5). Twelve of the patients had documented infections before GTF. Ten of the 14 courses (71%) were followed by survival to hospital discharge. All 5 patients who were intubated before GTF were extubated afterward. Two early deaths occurred due to invasive Aspergillus. No significant differences in monitoring laboratories were found. Ultimately, 8 of 13 (62%) patients in this group died. This case series documents the course of 13 septic neutropenic pediatric oncology patients who underwent a total of 14 GTF courses. GTFs were generally well tolerated with little decline in respiratory status or organ function. Short-term survival in this population was good whereas long-term outcome remains more difficult.