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Infections continue to be a serious problem for severely neutropenic oncology and haematopoietic progenitor cell ( HPC) transplant patients. Although it is now possible to collect much larger numbers of neutrophils ( PMNs) from donors stimulated with granulocyte colony-stimulating factor + corticosteroids, the efficacy of these 'modern' granulocyte/ PMN transfusions, with higher doses of PMNs, has not been established by convincing randomized control trials. Accordingly, they cannot be recommended for standard therapy at this time. [ABSTRACT FROM AUTHOR]

Summary. The predictable neutropenia that follows allogeneic stem cell transplantation (ASCT) may be associated with recurrence of previous life-threatening infection. We describe nine patients with either previous invasive aspergillosis (IA) or considered to be at high risk of developing IA who underwent ASCT with prophylactic granulocyte transfusions. The study group, when compared with a control group, had a significant reduction in the incidence and duration of fevers (P < 0·05) and maximum C-reactive protein (P < 0·05). There were significantly fewer days of neutropenia (P < 0·05). There was also radiological improvement of pulmonary infiltrates in four out of seven assessable patients. No serious toxicity was encountered in donors or recipients. We conclude that prophylactic granulocyte donations can be given safely, and that they significantly reduce the number of days of neutropenia. Further investigation is warranted to determine whether granulocyte donations can prevent the recurrence of IA in patients at risk of fungal infection. [ABSTRACT FROM AUTHOR]