{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T05:17:03Z","timestamp":1767849423543,"version":"3.49.0"},"reference-count":34,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T00:00:00Z","timestamp":1731628800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Background\/Objectives: Infections remain the leading cause of mortality among neutropenic patients with haematologic malignancies, making effective infection management crucial. Achieving a sufficient neutrophil count is essential for the elimination of pathogens. Granulocyte concentrate (GC) can be a treatment option for neutropenic patients with severe infections. This study aimed to evaluate the efficacy, safety, and impact on survival of GC transfusions in neutropenic children with severe infections treated over the past 13 years in a single centre. Methods: The retrospective study analysed clinical data from 60 children (median age 9.5 years) who received GC transfusions at our centre. Granulocytes were collected by apheresis from donors stimulated with granulocyte colony-stimulating factor. The majority of the patients (70%) were diagnosed with acute leukaemia. The main indications for GC were severe pneumonia (45%) and bacterial sepsis (38.33%). Results: The patients received 1 to 29 GC transfusions for 1 to 70 days, with a median time of administration of 3 days. Neutrophil counts increased to &gt;1000\/\u00b5L within a median of 5 days. GCs were well tolerated by most patients. One patient presented symptoms of anaphylaxis, the other acute lung injury related to transfusions, and alloimmunisation was reported in one patient. Of the patients analysed, 78.33% survived the infection that justified GC administration. We did not observe significant differences in survival depending on the aetiology of the infection. Conclusions: Based on our research, GC appears to be a beneficiary for neutropenic children with severe infections and reduces infection mortality rates. However, further well-designed randomised trials are needed to define its role in this setting.<\/jats:p>","DOI":"10.3390\/jpm14111107","type":"journal-article","created":{"date-parts":[[2024,11,15]],"date-time":"2024-11-15T08:28:13Z","timestamp":1731659293000},"page":"1107","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Use of Granulocyte Transfusions in the Management of Severe Infections Among Children with Neutropenia"],"prefix":"10.3390","volume":"14","author":[{"given":"Gabriela","family":"Mielecka-Jarmocik","sequence":"first","affiliation":[{"name":"Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland"},{"name":"Department of Pediatric Oncology and Hematology, University Children Hospital of Krakow, 30-663 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarzyna","family":"Szymbor","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walentyna","family":"Balwierz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland"},{"name":"Department of Pediatric Oncology and Hematology, University Children Hospital of Krakow, 30-663 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6867-2717","authenticated-orcid":false,"given":"Szymon","family":"Skocze\u0144","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland"},{"name":"Department of Pediatric Oncology and Hematology, University Children Hospital of Krakow, 30-663 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Le\u0144","sequence":"additional","affiliation":[{"name":"Department of Serology and Transfusion at the University Children\u2019s Hospital of Krakow, 30-663 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kinga","family":"Kania","sequence":"additional","affiliation":[{"name":"Department of Serology and Transfusion at the University Children\u2019s Hospital of Krakow, 30-663 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1212-7629","authenticated-orcid":false,"given":"Katarzyna","family":"Pawi\u0144ska-W\u0105sikowska","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, 30-663 Krakow, Poland"},{"name":"Department of Pediatric Oncology and Hematology, University Children Hospital of Krakow, 30-663 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Freedman, J.L., Beeler, D.M., Bowers, A., Bradford, N., Cheung, Y.T., Davies, M., Dupuis, L.L., Elgarten, C.W., Jones, T.M., and Jubelirer, T. (2023). Supportive Care in Pediatric Oncology: Opportunities and Future Directions. Cancers, 15.","DOI":"10.3390\/cancers15235549"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"167","DOI":"10.2478\/ahp-2019-0027","article-title":"Infectious complications in children and adults with hematological malignancies","volume":"50","year":"2019","journal-title":"Acta Haematol. Pol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1097\/PEC.0000000000002360","article-title":"Infections in Children With Cancer","volume":"37","author":"Karavanaki","year":"2021","journal-title":"Pediatr. Emerg. Care"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1002\/pbc.23416","article-title":"Prevention of bacterial infection in pediatric oncology: What do we know, what can we learn?","volume":"59","author":"Alexander","year":"2012","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1200\/JCO.22.02224","article-title":"Guideline for the Management of Fever and Neutropenia in Pediatric Patients With Cancer and Hematopoietic Cell Transplantation Recipients: 2023 Update","volume":"41","author":"Lehrnbecher","year":"2023","journal-title":"J. Clin. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"673","DOI":"10.2165\/00148581-200305100-00003","article-title":"The Role of Colony-Stimulating Factors and Granulocyte Transfusion in Treatment Options for Neutropenia in Children with Cancer","volume":"5","author":"Liang","year":"2003","journal-title":"Paediatr. Drugs"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1111\/j.1423-0410.2008.01159.x","article-title":"Granulocyte transfusions in neutropenic patients: Beneficial effects proven?","volume":"96","author":"Peters","year":"2009","journal-title":"Vox Sang."},{"key":"ref_8","unstructured":"Bodey, G.P., Buckley, M., Sathe, Y.S., Freireich, E.J., and Bethesda, M. (2024, August 05). Quantitative Relationships Between Circulating Leukocytes and Infection in Patients with Acute Leukemia. Available online: http:\/\/annals.org\/."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"321","DOI":"10.5603\/MRJ.a2022.0048","article-title":"Granulocyte transfusion vs. neutropenia\u2014Is there a chance to win this battle?","volume":"7","author":"Szumowski","year":"2022","journal-title":"Med. Res. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1256","DOI":"10.1016\/j.jcyt.2017.08.012","article-title":"Granulocyte transfusions: A concise review for practitioners","volume":"19","year":"2017","journal-title":"Cytotherapy"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12967-015-0724-5","article-title":"Granulocyte transfusions in children and adults with hematological malignancies: Benefits and controversies","volume":"13","author":"Cugno","year":"2015","journal-title":"J. Transl. Med."},{"key":"ref_12","first-page":"CD005339","article-title":"Granulocyte transfusions for treating infections in people with neutropenia or neutrophil dysfunction","volume":"2016","author":"Estcourt","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_13","first-page":"CD005341","article-title":"Granulocyte transfusions for preventing infections in people with neutropenia or neutrophil dysfunction","volume":"2015","author":"Estcourt","year":"2015","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Alves, J., Abreu, B., Palma, P., Alp, E., Vieceli, T., and Rello, J. (2023). Antimicrobial Stewardship on Patients with Neutropenia: A Narrative Review Commissioned by Microorganisms. Microorganisms, 11.","DOI":"10.3390\/microorganisms11051127"},{"key":"ref_15","unstructured":"Morin, P.-A., Ning, S., \u0141\u0119towska, M., and Rosiek, A.A. Granulocyte Concentrate. McMaster Textbook of Internal Medicine, Medycyna Praktyczna. Available online: https:\/\/empendium.com\/mcmtextbook\/chapter\/B31.II.15.62.3."},{"key":"ref_16","unstructured":"European Committee (Partial Agreement) on Blood Transfusion (2023). Guide to the Preparation, Use and Quality Assurance of Blood Components, European Directorate for the Quality of Medicines & HealthCare of the Council of Europe (EDQM). [21st ed.]. Available online: https:\/\/www.edqm.eu\/en\/blood-guide."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"103134","DOI":"10.1016\/j.transci.2021.103134","article-title":"Use of granulocyte transfusion in early period in life-threatening infections of pediatric hematology and oncology patients: A single-center experience","volume":"60","author":"Koc","year":"2021","journal-title":"Transfus. Apher. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1007\/s00520-006-0041-x","article-title":"G-CSF mobilised granulocyte transfusions in 32 paediatric patients with neutropenic sepsis","volume":"14","author":"Grigull","year":"2006","journal-title":"Support Care Cancer"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2082","DOI":"10.1016\/j.ejca.2007.07.018","article-title":"Granulocyte transfusions in neutropaenic children: A systematic review of the literature","volume":"43","author":"Weggelaar","year":"2007","journal-title":"Eur. J. Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e220","DOI":"10.1097\/MPH.0b013e31821ffdf1","article-title":"Effect and Safety of Granulocyte Transfusions in Pediatric Patients With Febrile Neutropenia or Defective Granulocyte Functions","volume":"33","author":"Atay","year":"2011","journal-title":"J Pediatr Hematol Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1007\/s12288-016-0737-0","article-title":"Granulocyte Transfusion Therapy in Childhood","volume":"33","author":"Aktekin","year":"2017","journal-title":"Indian J. Hematol. Blood Transfus."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1002\/jca.21818","article-title":"Efficacy and safety of granulocyte transfusion in children: A single-center experience","volume":"35","author":"Guzelkucuk","year":"2020","journal-title":"J. Clin. Apher."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1111\/j.1365-2141.2006.06312.x","article-title":"Haematological malignancies developing in previously healthy individuals who received haematopoietic growth factors: Report from the Research on Adverse Drug Events and Reports (RADAR) project","volume":"135","author":"Bennett","year":"2006","journal-title":"Br. J. Haematol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3655","DOI":"10.1182\/blood-2013-12-542464","article-title":"Lower risk of serious adverse events and no increased risk of cancer after PBSC versus bone marrow donation","volume":"123","author":"Pulsipher","year":"2014","journal-title":"Blood"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Wang, H., Wu, Y., Fu, R., Qu, W., Ruan, E., Wang, G., Liu, H., Song, J., Xing, L., and Guan, J. (2014). Granulocyte Transfusion Combined with Granulocyte Colony Stimulating Factor in Severe Infection Patients with Severe Aplastic Anemia: A Single Center Experience from China. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0088148"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"490","DOI":"10.3109\/14653249.2010.529889","article-title":"Therapeutic granulocyte transfusions for the treatment of febrile neutropenia in patients with hematologic diseases: A 10-year experience at a single institute","volume":"13","author":"Kim","year":"2011","journal-title":"Cytotherapy"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1007\/s00520-002-0394-8","article-title":"Granulocyte transfusions from G-CSF-stimulated donors for the treatment of severe infections in neutropenic pediatric patients with onco-hematological diseases","volume":"11","author":"Cesaro","year":"2003","journal-title":"Support Care Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1007\/s00431-016-2774-y","article-title":"Granulocyte transfusions in critically ill children with prolonged neutropenia: Side effects and survival rates from a single-center analysis","volume":"175","author":"Weingarten","year":"2016","journal-title":"Eur. J. Pediatr."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1159\/000351174","article-title":"Use of Healthy-Donor Granulocyte Transfusions to Treat Infections in Neutropenic Patients with Myeloid or Lymphoid Neoplasms: Experience in 74 Patients Treated with 373 Granulocyte Transfusions","volume":"131","author":"Safdar","year":"2014","journal-title":"Acta Haematol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2076","DOI":"10.1111\/trf.13099","article-title":"Role of granulocyte transfusions in invasive fusariosis: Systematic review and single-center experience","volume":"55","author":"Kadri","year":"2015","journal-title":"Transfusion"},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Teofili, L., Valentini, C.G., Di Blasi, R., Orlando, N., Fianchi, L., Zini, G., Sica, S., De Stefano, V., and Pagano, L. (2016). Dose-Dependent Effect of Granulocyte Transfusions in Hematological Patients with Febrile Neutropenia. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0159569"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1111\/j.1537-2995.2006.00996.x","article-title":"Safety and efficacy of therapeutic early onset granulocyte transfusions in pediatric patients with neutropenia and severe infections","volume":"46","author":"Sachs","year":"2006","journal-title":"Transfusion"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1007\/s12288-016-0727-2","article-title":"Changing Trends in the Use of Granulocyte Transfusions in Neutropenic Children with Sepsis in India","volume":"33","author":"Uppuluri","year":"2017","journal-title":"Indian J. Hematol. Blood Transfus."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"425","DOI":"10.3109\/08880018.2013.868562","article-title":"Granulocyte Transfusions for Children with Infection and Neutropenia or Granulocyte Dysfunction","volume":"31","author":"Soundar","year":"2014","journal-title":"Pediatr. Hematol. Oncol."}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/11\/1107\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:33:08Z","timestamp":1760113988000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/14\/11\/1107"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,15]]},"references-count":34,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11]]}},"alternative-id":["jpm14111107"],"URL":"https:\/\/doi.org\/10.3390\/jpm14111107","relation":{},"ISSN":["2075-4426"],"issn-type":[{"value":"2075-4426","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,15]]}}}