Use of G-CSF for granulocyte transfusion therapy

Patients with neutropenia, especially neutropenia following aggressive myel oablative therapy, are at high risk for developing infectious complications caused by bacteria and opportunistic fungi. Infections remain one of the l eading causes of treatment failure in patients with cancer. Thus, new and i nnovative therapeutic strategies are needed for management of neutropenic p atients with infection. Because neutrophils represent the first line of hos t defense, granulocyte transfusion therapy should be a logical therapeutic approach. Although such therapy has been employed sporadically for several decades, clinical benefit has been compromised by technical problems and lo w granulocyte yields resulting from inadequate donor stimulation. The disco very of granulocyte colony-stimulatng factor (G-CSF) as a means to elevate blood neutrophil counts when administered to normal donors has rekindled in terest in granulocyte transfusion therapy. Extensive experience has been ga ined worldwide with G-CSF in clinical practice, and adverse events have bee n minimal when G-CSF has been administered to patients or healthy persons i n human trials. This review focuses on the use of G-CSF in granulocyte tran sfusion therapy, including technical considerations of granulocyte leukaphe resis and storage, donor selection and stimulation, as well as treatment re sults and associated risks.