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Granulocyttransfusion bör övervägas vid neutropeni och allvarlig infektion [Granulocyte transfusion – when and how should it be used?]
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Immunology and Transfusion Medicine.
Akademiska sjukhuset - Hematologiska kliniken Uppsala, Sweden Akademiska sjukhuset - Hematologiska kliniken Uppsala, Sweden.
Akademiska sjukhuset - Klinisk immunologi och transfusionsmedicin Uppsala, Sweden Akademiska sjukhuset - Klinisk immunologi och transfusionsmedicin Uppsala, Sweden.
Karolinska Universitetssjukhuset - Centrum för allogen stamcellstransplantation Stockholm, Sweden .
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2018 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 115, article id EXUUArticle, review/survey (Refereed) Published
Abstract [en]

There are no randomized controlled trials proving the clinical benefit of granulocyte transfusions. However, clinical experience and a number of case studies suggest that granulocyte transfusions may be life-saving in certain situations. In our opinion granulocyte transfusions should be considered for patients with profound neutropenia and severe, life-threatening infection not responding to antibiotic or antifungal therapy. Since the clinical effect seems to be dose-dependent, the granulocyte concentrate should contain a large number of cells, which usually means that the donor should be mobilized with steroids and G-CSF. Regular blood donors as well as relatives to the patient can be used for granulocyte donations with apheresis technique after information of the process. Granulocyte transfusion should be given daily as long as the indication remains. The clinical efficacy of the transfusions should be evaluated daily.

Abstract [sv]

Granulocyttransfusion bör övervägas till patient med uttalad neutropeni och allvarlig infektion som inte svarat på antibiotika eller antimykotisk behandling.

Man bör transfundera en hög dos granulocyter, vilket normalt innebär att granulocytgivaren stimuleras med steroider och granulocytkolonistimulerande faktor (G-CSF).

Både blodgivare och anhöriga kan användas som granulocytgivare efter information om processen.

Granulocyttransfusion ges dagligen så länge indikationen kvarstår.

Daglig bedömning av transfusionseffekten ska göras.

Place, publisher, year, edition, pages
Stockholm, Sweden: Läkartidningen Förlag , 2018. Vol. 115, article id EXUU
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Hematology
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URN: urn:nbn:se:liu:diva-154949PubMedID: 29558012OAI: oai:DiVA.org:liu-154949DiVA, id: diva2:1294336
Available from: 2019-03-07 Created: 2019-03-07 Last updated: 2019-10-10Bibliographically approved

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Berlin, Gösta

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Berlin, GöstaCherif, HonarKnutson, FolkeMattsson, JonasAxdorph Nygell, Ulla
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Division of Neuro and Inflammation ScienceFaculty of Medicine and Health SciencesDepartment of Clinical Immunology and Transfusion Medicine
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