Scali 1978.

Methods	Parallel RCT (Between 1973 and 1977) (number of centres not reported) Switzerland
Participants	Acute leukaemias and predominantly acute myeloid leukaemia (as first treatment i.e. not refractory and not relapsed) Inclusion criteria: Patients with acute leukaemia or blastic phase of chronic myeloid leukaemia if the neutrophil count was < 0.25 x 109/L, and if infection was documented or strongly suspected. The eligibility criteria for children also required culture‐positive microbiology results. Exclusion criteria: No patient was eligible unless he was under treatment for acute leukaemia Age range not reported N = 25 patients included in the analysis, Acute myeloid leukaemia = 23, Acute lymphocytic leukaemia = 2. All participants were receiving induction chemotherapy Arm 1 (Granulocyte transfusions): N = 13 Arm 2 (Control): N = 12
Interventions	Granulocyte dose: average 2.9 x 1010 granulocytes given/day to each patient. Total dose received by patients from all transfusions 6.6 x 1010, range 1.7 to 14.7 x 1010 Granulocyte method of collection: continuous flow (cell separator) centrifugation Selection of donors: ABO‐compatible Pre‐medication of donors: not reported Initiation of granulocyte transfusions: neutropenia < 0.5 x 109/L & fever > 380C (at least 3 out of 4 measurements in 24 hours) & antibiotics given for more than 24hrs without response or recurrence after initial improvement & hypocellular bone marrow aspirate Frequency of granulocyte transfusions: Daily Termination of granulocyte transfusions: Not reported. Granulocytes were given for a total mean number of 2.7 days (range 1 to 5 days).
Outcomes	Primary Outcome(s): Not reported Secondary Outcome(s): Not reported
Definition(s) of infection	Infections were retrospectively divided into: clinically and microbiologically documented; clinically definite source of infection (e.g. severe soft tissue infection even if no fever), and fever of unknown origin.
Definition of neutropenia	Neutrophil count < 0.5 x 109/L
Co‐interventions	Therapeutic antibiotics: All patients received gentamicin: in 21 cases this was combined with cephalothin or carbenicillin, or both; in 4 cases it was combined with other antibiotics. G‐CSF: G‐CSF not licensed by the Food and Drug Administration (FDA) until 1991. Therapeutic antifungals: Not reported
Notes	Randomised: Patients were not randomised until antibiotics were started for presumed or proven infection and a bone marrow aspirate had been performed that showed a pronounced hypocellularity or a complete aplasia with lack of myelopoiesis. Trial registration: none identified Sources of funding: Not reported Conflicts of Interest: Not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	Method of randomisation not reported
Allocation concealment (selection bias)	Unclear risk	Method of allocation concealment not reported
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Not reported
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Not reported
Incomplete outcome data (attrition bias) All outcomes	Unclear risk	Unclear whether there was loss to follow‐up
Selective reporting (reporting bias)	Unclear risk	No protocol was available
Other bias	Unclear risk	Study is poorly reported, therefore the study may be at significant risk of bias. The more serious infections extending sepsis, pneumonia and soft tissue abscesses were unequally distributed between the two groups and overall were more common in the granulocyte transfusion group