Description

While the introduction of recombinant granulocyte colony stimulating factor (Neupogen) has greatly reduced the need for use of granulocyte products, occasionally certain patients may benefit from their use.


 

Indications:

(1) appropriate condition

(1a) neutropenia with WBC count < 500 per µL

(1a1) The neutropenia is due to myeloid hypoplasia.

(1a2) There is a reasonable chance for recovery of bone marrow function.

(1b) Some physicians include documented granulocytic dysfunction such as chronic granulomatous disease.

(2) evidence of bacterial infection

(2a) Fever for 24-48 hours, unresponsive to appropriate antibiotic therapy

(2b) Bacterial sepsis unresponsive to antibiotics or other modes of therapy

 

Nonindications:

(1) prophylactic administration

(2) localized infection

(3) infections due to organisms other than bacteria

 

Recommendations:

(1) The product should be irradiated to avoid risk of graft-versus-host reaction.

(2) Donors should be CMV-seronegative to avoid CMV infection in the recipient.

(3) The product should not be transfused through a leukocyte reduction filter.

 


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