Combined treatment with amphotericin-B and granulocyte transfusion from G-CSF-stimulated donors in an aplastic patient with invasive aspergillosis undergoing bone marrow transplantation

Haematologica. 1997 Jan-Feb;82(1):71-2.

Abstract

Granulocyte transfusions from G-CSF stimulated donors were added to standard anti-infective treatment in preparation for and during allogeneic bone marrow transplantation in a young man affected by very severe acute aplastic anemia and invasive aspergillosis. Nine concentrates with a mean neutrophil content of 18.7 x 10(9)/L (2.6 x 10(8)/kg patient b.w.) were transfused before and after marrow infusion. An impressive clinical improvement was noticed after each granulocyte transfusion, although this was not always paralleled by a neutrophil increase in the peripheral blood. Engraftment (N > 0.5 x 10(9)/L and Plt > 25 x 10(9)/L) was verified at +16 and +40 days, respectively. The patient is currently in complete hematological and microbiological remission 14 months after transplantation. Granulocyte apheresis from G-CSF stimulated donors provides a high number of activated neutrophils. At the dose given (300 micrograms/day) donor tolerance to G-CSF was excellent. This new approach is indicated when life-threatening infections develop in patients exposed to prolonged severe neutropenia.

Publication types

  • Case Reports

MeSH terms

  • Acyclovir / therapeutic use
  • Adult
  • Amphotericin B / therapeutic use*
  • Anemia, Aplastic / complications
  • Anemia, Aplastic / therapy*
  • Antifungal Agents / therapeutic use*
  • Antiviral Agents / therapeutic use
  • Aspergillosis / drug therapy
  • Aspergillosis / etiology
  • Aspergillosis / therapy*
  • Aspergillus fumigatus
  • Bone Marrow Transplantation*
  • Combined Modality Therapy
  • Filgrastim
  • Granulocyte Colony-Stimulating Factor / therapeutic use
  • Granulocyte-Macrophage Colony-Stimulating Factor / therapeutic use
  • Granulocytes / transplantation*
  • Humans
  • Immunocompromised Host
  • Itraconazole / therapeutic use
  • Leukocyte Transfusion*
  • Lung Diseases, Fungal / drug therapy
  • Lung Diseases, Fungal / etiology
  • Lung Diseases, Fungal / therapy
  • Male
  • Recombinant Proteins / therapeutic use
  • Remission Induction

Substances

  • Antifungal Agents
  • Antiviral Agents
  • Recombinant Proteins
  • Granulocyte Colony-Stimulating Factor
  • Itraconazole
  • Amphotericin B
  • Granulocyte-Macrophage Colony-Stimulating Factor
  • molgramostim
  • Filgrastim
  • Acyclovir