Prophylactic granulocyte transfusions: results of a randomized controlled trial in patients with acute myelogenous leukemia

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Abstract
A prospective randomized and controlled clinical trial of prophylactic granulocyte transfusions was conducted to reduce the morbidity and mortality from infection in newly diagnosed adults with acute myelogenous leukemia. Granulocytes were harvested from normal donors by cytapheresis; transfused patients received a median of 1.45 .times. 1010 granulocytes (range 0.28-3.45 .times. 1010) on alternate days during bone marrow aplasia caused by initial induction chemotherapy [adriamycin, vincristine, cytosine arabinoside, prednisolone]. Transfusions were started if the absolute peripheral granulocyte count was < 500/.mu.l. Thirteen patients received from 1-12 granulocyte transfusions; 11 control patients received no granulocytes. No significant advantage was demonstrated in the transfused patients compared with controls with regard to the following: deaths due to infection, reduction in the frequency of febrile episodes, delay in the onset of fever, reduction in the length of febrile episodes, or reduction in the frequency of proven infection.