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Granulocyte transfusions could benefit patients with severe oral mucositis after allogeneic hematopoietic stem cell transplantation
Karolinska Inst, Dept Oncol Pathol, Stockholm, Sweden;Karolinska Inst, Dept Clin Neurosci, Therapeut Immune Design, Stockholm, Sweden;Karolinska Univ Hosp, Cell Therapy & Allogene Stem Cell Transplantat CA, Stockholm, Sweden.ORCID iD: 0000-0001-7320-8839
Karolinska Univ Hosp, Dept Clin Immunol & Transfus Med, Stockholm, Sweden;Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Stockholm, Sweden.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. KFUE, Uppsala, Sweden.ORCID iD: 0000-0003-0520-4312
Karolinska Inst, Dept Dent Med, Stockholm, Sweden.
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2019 (English)In: Vox Sanguinis, ISSN 0042-9007, E-ISSN 1423-0410, Vol. 114, no 7, p. 769-777Article in journal (Refereed) Published
Abstract [en]

Background and objectives

Mucositis is a common complication after allogeneic hematopoietic stem cell transplantation (HSCT), and is caused by a combination of conditioning‐induced mucosal damage and severe neutropenia. The symptoms include oral and abdominal pain, inability to swallow food and fluids, and severe diarrhoea. Severe mucositis is associated with increased risk of Graft‐versus‐Host disease and infection. Granulocyte transfusions (GCX) could be a treatment option, and our objective was to study its feasibility and potential benefits.

Material and methods

This retrospective, single‐centre study included 30 patients receiving GCX because of severe oral mucositis after HSCT during 2005–2017. Clinical outcome, response to GCX, change in opiate administration and adverse events were studied.

Results

Twenty‐seven patients received GCX from donors pre‐treated with steroids and G‐CSF, and three from donors pre‐treated with steroids only. Overall response was 83% (24/29 evaluable patients). Fifteen patients reached a complete response. In 14 of 24 responders, a reduction of the administration of opiate pain relief was seen. In eight patients this reduction was ≥50% of the dose. Adverse events (AEs) were reported in 14 cases, and were mild to moderate, and well manageable with symptomatic treatment. No life‐threatening or fatal AEs were recorded.

Conclusions

These results indicate that GCX could be a safe and effective treatment for oral mucositis after HSCT with the potential to reduce the necessity of opiate analgesic treatment in this disorder. No severe AEs were seen in this study, but the risk for severe pulmonary AEs after GCX needs to be considered.

Place, publisher, year, edition, pages
2019. Vol. 114, no 7, p. 769-777
Keywords [en]
stem cell transplantation, cellular therapy, transfusion therapy, granulocyte transfusion, oral mucositis
National Category
Gastroenterology and Hepatology Hematology
Identifiers
URN: urn:nbn:se:uu:diva-398815DOI: 10.1111/vox.12835ISI: 000481199700001PubMedID: 31402469OAI: oai:DiVA.org:uu-398815DiVA, id: diva2:1378760
Funder
Swedish Research CouncilSwedish Childhood Cancer FoundationSwedish Society for Medical Research (SSMF)Stockholm County CouncilAvailable from: 2019-12-13 Created: 2019-12-13 Last updated: 2019-12-13Bibliographically approved

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Remberger, Mats

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