Although granulocyte transfusion has been available for many years, its use has waned over the past decade, partly because of advances in antimicrobial therapy and the availability of hemopoietic growth factors. In addition, early studies showed that no clinical benefit was demonstrated, primarily because the collection method prevented sufficient numbers of granulocytes from being collected, thus requiring frequent transfusions, and the function of the cells collected was defective. There have also been concerns regarding the risk of cytomegalovirus infections, transfusion-associated graft versus host disease, and the development of acute respiratory distress syndrome following transfusion of granulocytes. Efforts to improve granulocyte collection following granulocyte colony-stimulating factor administration to donors is now being considered. The use of granulocyte colony-stimulating factor offers many potential advantages. Its ability to increase granulocyte numbers would allow collection of enough cells to reflect physiological production. In addition, it offers the advantage of granulocyte collection with potentially enhanced functional capability and increased survival secondary to delayed apoptosis. In a recent study, a high yield of granulocytes was obtained from family members or volunteer donors following granulocyte colony-stimulating factor administration. Post-transfusion, granulocyte recovery and survival were excellent and sustained, with normal in vitro function (Wy®.si.19.9.6). Further studies are required to evaluate efficacy and to monitor long-term toxicity of granulocyte colony-stimulating factor in donors and granulocytes in recipients.
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