COMBINED TREATMENT WITH AMPHOTERICIN-B AND GRANULOCYTE TRANSFUSION FROM G-CSF-STIMULATED DONORS IN AN APLASTIC PATIENT WITH INVASIVE ASPERGILLOSIS UNDERGOING BONE-MARROW TRANSPLANTATION

Granulocyte transfusions from C-CSF stimulated donors were added to st andard anti-infective treatment in preparation for and during allogene ic bone marrow transplantation in a young man affected by very severe acute aplastic anemia and invasive aspergillosis. Nine concentrates wi th a mean neutrophil content of 18.7x10(9)/L (2.6x10(8)/kg patient b.w .) were transfused before and after marrow infusion. An impressive cli nical Improvement was noticed after each granulocyte transfusion, alth ough this was not always paralleled by a neutrophil increase in the pe ripheral blood. Engraftment (N>0.5x10(9)/L and Plt>25x10(9)/L) was ver ified at +16 and +40 days, respectively. The patient is currently in c omplete hematological and microbiological remission 14 months after tr ansplantation. Granulocyte apheresis from CI-CSF stimulated donors pro vides a high number of activated neutrophils. At the dose given (300 m u g/day) donor tolerance to C-CSF was excellent. This new approach is indicated when life-threatening infections develop in patients exposed to prolonged severe neutropenia. (C) 1997, Ferrata Storti Foundation.