A controlled trial of prophylactic granulocyte transfusions during induction chemotherapy for acute nonlymphoblastic leukemia

Abstract

Thirty-five noninfected patients undergoing induction chemotherapy for acute nonlymphoblastic leukemia (ANLL) were randomized to either receive (19 patients) or not receive (16 control patients) prophylactic granulocyte transfusions (PGT) when their granulocyte count fell below 0.5 X 10(9)/1. Both groups received identical anti-infectious and supportive care except for granulocyte transfusions. The authors found a nonstatistically significant decrease of the infection rate in the prophylactic group. However, the bacteriologically documented infections and septicemia incidence was significantly higher in the control than in the prophylactic group (P less than 0.05). In the control group they observed in 8 of 16 cases life-threatening infections in contrast with only 1 case in the prophylactic group (P less than 0.01). A significant reduction of deaths due to infectious causes in the prophylactic versus control group were also found (P less than 0.05). The authors did not find an increase of pneumonia or pulmonary infiltrates in the patients belonging to prophylactic in comparison to control group.