Prophylactic Granulocyte Transfusions During Chemotherapy of Acute Nonlymphocytic Leukemia

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Abstract
Noninfected patients (46) undergoing induction chemotherapy for acute nonlymphocytic leukemia were randomized to receive (25 patients) or not to receive (21 control patients) prophylactic granulocyte transfusions when their granulocyte count fell below 0.5 .times. 109/l [due to the toxic side effects of the chemotherapy]. Septicemia was less frequent in the patients who received transfusions (2 in 25 patients) than in the control patients (5 in 21 patients), but this difference was not statistically significant (P = 0.28). Moreover, pneumonia was more frequent among the transfused patients (12 in 25 patients vs. 2 in 21 patients, P = 0.01). There were no significant differences between the 2 groups in the frequency of other documented infections, the achievement or duration of remission, or survival. Recipients of prophylactic granulocyte transfusions had a higher prevalence of cytomegalovirus infections (13 in 21 patients vs. 5 in 19 patients, P = 0.03). Prophylactic granulocyte transfusions apparently have no statistically significant effect on the frequency of septicemia or other infections, do not enhance remission rates or survival, and could be associated with an increased risk for pulmonary complications and cytomegalovirus infections.