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The management of 33 febrile episodes in neutropenic patients suffering from acute leukaemia and other cancers is described. In 32 out of 33 episodes, the fever subsided. One patient died of cerebral haemorrhage while infected. The most common clinical sites of infection were, in order of frequency, the chest, the throat and the skin. Positive cultures were obtained in about half the episodes, the most common site being the throat followed by blood and sputum. The most common organisms isolated were Gram negative. Eighty‐four per cent of febrile episodes occurred with neutrophil counts of less than 500/mm3, and in the majority of these, less than 100 neutrophils per cubic millimetre. All patients were reverse barrier nursed and on becoming febrile were given 48 hours of parenteral antibiotic therapy. The most common antibiotic combination used was gentamicin and cephalothin. At 48 hours, granulocyte transfusion and a third antibiotic were added to the regimen of patients not responding. The percentage response to antibiotics alone, in this series, at 58% was similar to that of other series, but the mortality experienced was lower.

A pilot study of granulocyte support for neutropenic infected patients by means of white cells collected from the Aminco Celltrifuge at the Peter MacCallum Clinic showed acceptable side effects in donor and recipient, and an encouraging recovery occurred in two out of four patients treated. White cell filtration leukopheresis was introduced at the Alfred Hospital Haematology and Medical Oncology Unit in November, 1975, for supportive therapy of all patients with white cell counts below 500/mm3who had sustained febrile episodes (temperatures greater than 38$dgC for more than 48 hours) while receiving appropriate or empiric parenteral antibiotic therapy. A minimum of four or more daily transfusions was given from group and cross‐matched compatible donors until fever lysis, recovery of the neutrophil count to over 500/mm3or death. Of 13 patients given white cell support, 12 survived and were discharged from hospital. One patient died having received only one transfusion when he was moribund. We believe that white cell filtration leukopheresis cell support is useful when used with parenteral antibiotic therapy for infected neutropenic patients, and it has resulted in a high rate of recovery from life‐threatening infection in patients at risk.