Skip to main content
Canadian Medical Association Journal logoLink to Canadian Medical Association Journal
. 1984 Mar 1;130(5):593–597.

Pulmonary complications in patients receiving granulocyte transfusions and amphotericin B.

E J Bow, M L Schroeder, T J Louie
PMCID: PMC1875734  PMID: 6697270

Abstract

To evaluate the possibility that in febrile granulocytopenic patients amphotericin B given along with granulocyte transfusions could increase the incidence of pulmonary complications, we studied 43 severely granulocytopenic patients during 46 episodes of fever. Granulocytes were administered as part of the clinical protocol to all 19 patients who had clinically or microbiologically documented infection; the other 24 patients were randomly allocated to treatment with granulocytes (13 patients) or without granulocytes (11 patients). In all, 32 patients received granulocyte transfusions during 35 episodes of fever. Pulmonary complications developed in six patients in each of the two randomized groups. The incidence of pulmonary complications was not influenced by the number of granulocyte transfusions or by the number of granulocytes per transfusion. Pulmonary complications were significantly more likely to occur in patients with fungal infections. Amphotericin B was given according to clinical indications; 21 patients in all received it. Survival was significantly poorer in patients with pulmonary complications, but the administration of amphotericin B was not related either to survival or to the incidence of pulmonary complications. We conclude that pulmonary complications and poor prognosis are related to underlying pulmonary fungal infection and not to any interaction between amphotericin B and granulocyte transfusions.

Full text

PDF
597

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alavi J. B., Root R. K., Djerassi I., Evans A. E., Gluckman S. J., MacGregor R. R., Guerry D., Schreiber A. D., Shaw J. M., Koch P. A randomized clinical trial of granulocyte transfusions for infection in acute leukemia. N Engl J Med. 1977 Mar 31;296(13):706–711. doi: 10.1056/NEJM197703312961302. [DOI] [PubMed] [Google Scholar]
  2. Björkstén B., Ray C., Quie P. G. Inhibition of human neutrophil chemotaxis and chemiluminescence by amphotericin B. Infect Immun. 1976 Jul;14(1):315–317. doi: 10.1128/iai.14.1.315-317.1976. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Chunn C. J., Starr P. R., Gilbert D. N. Neutrophil toxicity of amphotericin B. Antimicrob Agents Chemother. 1977 Aug;12(2):226–230. doi: 10.1128/aac.12.2.226. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Dana B. W., Durie B. G., White R. F., Huestis D. W. Concomitant administration of granulocyte transfusions and amphotericin B in neutropenic patients: absence of significant pulmonary toxicity. Blood. 1981 Jan;57(1):90–94. [PubMed] [Google Scholar]
  5. Graw R. G., Jr, Herzig G., Perry S., Henderson E. S. Normal granulocyte transfusion therapy: treatment of septicemia due to gram-negative bacteria. N Engl J Med. 1972 Aug 24;287(8):367–371. doi: 10.1056/NEJM197208242870801. [DOI] [PubMed] [Google Scholar]
  6. Herzig R. H., Herzig G. P., Graw R. G., Jr, Bull M. I., Ray K. K. Successful granulocyte transfusion therapy for gram-negative septicemia. A prospectively randomized controlled study. N Engl J Med. 1977 Mar 31;296(13):701–705. doi: 10.1056/NEJM197703312961301. [DOI] [PubMed] [Google Scholar]
  7. Higby D. J., Burnett D. Granulocyte transfusions: current status. Blood. 1980 Jan;55(1):2–8. [PubMed] [Google Scholar]
  8. Higby D. J., Yates J. W., Henderson E. S., Holland J. F. Filtration leukapheresis for granulocyte transfusion therapy. Clinical and laboratory studies. N Engl J Med. 1975 Apr 10;292(15):761–766. doi: 10.1056/NEJM197504102921501. [DOI] [PubMed] [Google Scholar]
  9. Pizzo P. A., Robichaud K. J., Gill F. A., Witebsky F. G. Empiric antibiotic and antifungal therapy for cancer patients with prolonged fever and granulocytopenia. Am J Med. 1982 Jan;72(1):101–111. doi: 10.1016/0002-9343(82)90594-0. [DOI] [PubMed] [Google Scholar]
  10. Strauss R. G., Connett J. E., Gale R. P., Bloomfield C. D., Herzig G. P., McCullough J., Maguire L. C., Winston D. J., Ho W., Stump D. C. A controlled trial of prophylactic granulocyte transfusions during initial induction chemotherapy for acute myelogenous leukemia. N Engl J Med. 1981 Sep 10;305(11):597–603. doi: 10.1056/NEJM198109103051101. [DOI] [PubMed] [Google Scholar]
  11. Vogler W. R., Winton E. F. A controlled study of the efficacy of granulocyte transfusions in patients with neutropenia. Am J Med. 1977 Oct;63(4):548–555. doi: 10.1016/0002-9343(77)90200-5. [DOI] [PubMed] [Google Scholar]
  12. Ward H. N. Pulmonary infiltrates associated with leukoagglutinin transfusion reactions. Ann Intern Med. 1970 Nov;73(5):689–694. doi: 10.7326/0003-4819-73-5-689. [DOI] [PubMed] [Google Scholar]
  13. Winston D. J., Ho W. G., Gale R. P. Prophylactic granulocyte transfusions during chemotherapy of acute nonlymphocytic leukemia. Ann Intern Med. 1981 May;94(5):616–622. doi: 10.7326/0003-4819-94-5-616. [DOI] [PubMed] [Google Scholar]
  14. Winston D. J., Ho W. G., Gale R. P. Therapeutic granulocyte transfusions for documented infections. A controlled trial in ninety-five infectious granulocytopenic episodes. Ann Intern Med. 1982 Oct;97(4):509–515. doi: 10.7326/0003-4819-97-4-509. [DOI] [PubMed] [Google Scholar]
  15. Wright D. G., Robichaud K. J., Pizzo P. A., Deisseroth A. B. Lethal pulmonary reactions associated with the combined use of amphotericin B and leukocyte transfusions. N Engl J Med. 1981 May 14;304(20):1185–1189. doi: 10.1056/NEJM198105143042001. [DOI] [PubMed] [Google Scholar]

Articles from Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES