Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Jun;65(6):1111-1123.
doi: 10.1111/trf.18263. Epub 2025 May 15.

Differences in the product characteristics and clinical use of granulocytes for transfusion: The BEST Collaborative study

Lorna Cain  1   2 , Charles Lafrance  3   4   5 , Suzy Morton  6   7 , Catherine Latour  3 , Mélissa Girard  3 , Pierre Tiberghien  8   9 , Virginie de la Taille  8 , Suvro Sankha Datta  10 , Mrigender Singh Virk  11 , Jennifer Andrews  12 , Vered Yahalom  13   14 , Ana María Pugliese  15 , Romina Alba  15 , Richard Charlewood  16 , Susy Kirwan  16 , Ana Paula Hitomi Yokoyama  17 , Jose Mauro Kutner  17 , Eva Alonso Nogues  18 , Nuria Martinez I Llonch  18 , James Daly  19 , David O Irving  19 , Torsten J Schulze  20   21 , Elise Huisman  22   23 , Kaatje Le Poole  22 , Hans Vrielink  22 , Nabiha H Saifee  24 , Monica B Pagano  25 , Simon Stanworth  1   2 ; Biomedical Excellence for Safer Transfusion Collaborative
Affiliations
Multicenter Study

Differences in the product characteristics and clinical use of granulocytes for transfusion: The BEST Collaborative study

Lorna Cain et al. Transfusion. 2025 Jun.

Abstract

Background: Whether granulocytes for transfusion are beneficial remains uncertain, although some evidence suggests that efficacy may be dose-related. Granulocytes are mostly produced by apheresis procedure, but other means of production are increasingly used.

Methods: Centers that produce and/or use granulocytes were recruited through the BEST Collaborative and completed a detailed survey of granulocyte manufacture, specifications, clinical use, operational considerations, and data collection initiatives.

Results: Fifteen national, regional, and local producers and/or users of granulocytes were included. Granulocytes were produced from apheresis procedure (n = 10), pooled buffy coats (n = 2), single buffy coats (n = 4) or pooling of residual leukocyte units from whole blood processing (n = 1). The mean adult dose of granulocytes reported was 1.6 to 3.7 × 1010 for apheresis, and 1.8 to 2.2 × 1010 for pooled buffy coat granulocytes. For apheresis procedure donations, donor stimulation included steroids and/or granulocyte colony-stimulating factor. Centers providing whole blood-derived granulocytes reported shorter times from request to delivery than those using apheresis procedure products. Indications and product selection criteria were similar. The most frequently reported challenges with granulocytes were donor availability for apheresis procedure (n = 7), short shelf life (n = 5) and lack of evidence of efficacy (n = 5). The cost of one unit of apheresis procedure granulocytes ranged from 568 to 7500 PPP-USD, and for one pooled buffy coat unit was from 2208 to 2822 PPP-USD.

Conclusions: We have highlighted differences in granulocyte production that are relevant for the design and interpretation of much needed international clinical studies.

Keywords: blood; buffy coats; granulocytes; transfusion.

PubMed Disclaimer

Conflict of interest statement

The authors have disclosed no conflicts of interest. PT and VdlT are employed by Etablissement Français du Sang (EFS), the French transfusion public service in charge of blood donation and blood component manufacturing, testing and issuing in France.

Figures

FIGURE 1
FIGURE 1
The most frequently reported challenges with granulocytes for transfusion.
See this image and copyright information in PMC

References

    1. Netelenbos T, Massey E, de Wreede LC, Harding K, Hamblin A, Sekhar M, et al. The burden of invasive infections in neutropenic patients: incidence, outcomes, and use of granulocyte transfusions. Transfusion. 2019;59:160–168. - PMC - PubMed
    1. Estcourt LJ, Stanworth S, Doree C, Blanco P, Hopewell S, Trivella M, et al. Granulocyte transfusions for preventing infections in people with neutropenia or neutrophil dysfunction. Cochrane Database Syst Rev. 2015;2015:Cd005341. - PMC - PubMed
    1. Estcourt LJ, Stanworth SJ, Hopewell S, Doree C, Trivella M, Massey E. Granulocyte transfusions for treating infections in people with neutropenia or neutrophil dysfunction. Cochrane Database Syst Rev. 2016;4:Cd005339. - PMC - PubMed
    1. Price TH, Boeckh M, Harrison RW, McCullough J, Ness PM, Strauss RG, et al. Efficacy of transfusion with granulocytes from G‐CSF/dexamethasone‐treated donors in neutropenic patients with infection. Blood. 2015;126(18):2153–2161. 10.1182/blood-2015-05-645986 - DOI - PMC - PubMed
    1. Bashir S, Stanworth S, Massey E, Goddard F, Cardigan R. Neutrophil function is preserved in a pooled granulocyte component prepared from whole blood donations. Br J Haematol. 2008;140:701–711. - PubMed

Publication types

LinkOut - more resources