Granulocyte transfusions in hematologic malignancy patients with invasive pulmonary aspergillosis: Outcomes and complications

I. I. Raad Prof., A. M. Chaftari, M. M. Al Shuaibi, Y. Jiang, W. Shomali, J. E. Cortes, B. Lichtiger, R. Y. Hachem

Research output: Contribution to journalArticle

Abstract

Background: Granulocyte transfusions (GTXs) have been used successfully as an adjunctive treatment option for invasive infections in some neutropenic patients with underlying hematologic malignancy (HM). Patients and methods: We sought to determine the impact of GTX as an adjunct to antifungal therapy in 128 patients with HM and prolonged neutropenia (>14 days) with a proven or probable invasive aspergillosis (IA) infection by retrospectively reviewing our institutional database. Results: Fifty-three patients received GTX and 75 did not. By univariate analysis, patients with invasive pulmonary aspergillosis who received GTX were less likely to respond to antifungal therapy (P = 0.03), and more likely to die of IA (P = 0.009) when compared with the non-GTX group. Among patients who received GTX, 53% developed a pulmonary reaction. Furthermore, IA-related death was associated with the number of GTX given (P = 0.018) and the early initiation of GTX within 7 days after starting antifungal therapy (P = 0.001). By multivariate competing risk analysis, patients who received GTX were more likely to die of IA than patients who did not receive GTX (P = 0.011). Conclusions: Our study suggests that GTX does not improve response to antifungal therapy and is associated with worse outcomes of IA infection in HM patients, particularly those with pulmonary involvement.

Original languageEnglish (US)
Article numbermdt110
Pages (from-to)1873-1879
Number of pages7
JournalAnnals of Oncology
Volume24
Issue number7
DOIs
StatePublished - Jul 1 2013
Externally publishedYes

Fingerprint

Invasive Pulmonary Aspergillosis
Hematologic Neoplasms
Granulocytes
Aspergillosis
Infection
Therapeutics
Lung
Neutropenia
Databases

Keywords

  • Aspergillosis
  • Granulocyte transfusions
  • Hematologic malignancy

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Raad Prof., I. I., Chaftari, A. M., Al Shuaibi, M. M., Jiang, Y., Shomali, W., Cortes, J. E., ... Hachem, R. Y. (2013). Granulocyte transfusions in hematologic malignancy patients with invasive pulmonary aspergillosis: Outcomes and complications. Annals of Oncology, 24(7), 1873-1879. [mdt110]. https://doi.org/10.1093/annonc/mdt110

Granulocyte transfusions in hematologic malignancy patients with invasive pulmonary aspergillosis : Outcomes and complications. / Raad Prof., I. I.; Chaftari, A. M.; Al Shuaibi, M. M.; Jiang, Y.; Shomali, W.; Cortes, J. E.; Lichtiger, B.; Hachem, R. Y.

In: Annals of Oncology, Vol. 24, No. 7, mdt110, 01.07.2013, p. 1873-1879.

Research output: Contribution to journalArticle

Raad Prof., II, Chaftari, AM, Al Shuaibi, MM, Jiang, Y, Shomali, W, Cortes, JE, Lichtiger, B & Hachem, RY 2013, 'Granulocyte transfusions in hematologic malignancy patients with invasive pulmonary aspergillosis: Outcomes and complications', Annals of Oncology, vol. 24, no. 7, mdt110, pp. 1873-1879. https://doi.org/10.1093/annonc/mdt110
Raad Prof., I. I. ; Chaftari, A. M. ; Al Shuaibi, M. M. ; Jiang, Y. ; Shomali, W. ; Cortes, J. E. ; Lichtiger, B. ; Hachem, R. Y. / Granulocyte transfusions in hematologic malignancy patients with invasive pulmonary aspergillosis : Outcomes and complications. In: Annals of Oncology. 2013 ; Vol. 24, No. 7. pp. 1873-1879.
@article{d5d49b816ea84b61b55fe0db72228c65,
title = "Granulocyte transfusions in hematologic malignancy patients with invasive pulmonary aspergillosis: Outcomes and complications",
abstract = "Background: Granulocyte transfusions (GTXs) have been used successfully as an adjunctive treatment option for invasive infections in some neutropenic patients with underlying hematologic malignancy (HM). Patients and methods: We sought to determine the impact of GTX as an adjunct to antifungal therapy in 128 patients with HM and prolonged neutropenia (>14 days) with a proven or probable invasive aspergillosis (IA) infection by retrospectively reviewing our institutional database. Results: Fifty-three patients received GTX and 75 did not. By univariate analysis, patients with invasive pulmonary aspergillosis who received GTX were less likely to respond to antifungal therapy (P = 0.03), and more likely to die of IA (P = 0.009) when compared with the non-GTX group. Among patients who received GTX, 53{\%} developed a pulmonary reaction. Furthermore, IA-related death was associated with the number of GTX given (P = 0.018) and the early initiation of GTX within 7 days after starting antifungal therapy (P = 0.001). By multivariate competing risk analysis, patients who received GTX were more likely to die of IA than patients who did not receive GTX (P = 0.011). Conclusions: Our study suggests that GTX does not improve response to antifungal therapy and is associated with worse outcomes of IA infection in HM patients, particularly those with pulmonary involvement.",
keywords = "Aspergillosis, Granulocyte transfusions, Hematologic malignancy",
author = "{Raad Prof.}, {I. I.} and Chaftari, {A. M.} and {Al Shuaibi}, {M. M.} and Y. Jiang and W. Shomali and Cortes, {J. E.} and B. Lichtiger and Hachem, {R. Y.}",
year = "2013",
month = "7",
day = "1",
doi = "10.1093/annonc/mdt110",
language = "English (US)",
volume = "24",
pages = "1873--1879",
journal = "Annals of Oncology",
issn = "0923-7534",
publisher = "Oxford University Press",
number = "7",

}

TY - JOUR

T1 - Granulocyte transfusions in hematologic malignancy patients with invasive pulmonary aspergillosis

T2 - Outcomes and complications

AU - Raad Prof., I. I.

AU - Chaftari, A. M.

AU - Al Shuaibi, M. M.

AU - Jiang, Y.

AU - Shomali, W.

AU - Cortes, J. E.

AU - Lichtiger, B.

AU - Hachem, R. Y.

PY - 2013/7/1

Y1 - 2013/7/1

N2 - Background: Granulocyte transfusions (GTXs) have been used successfully as an adjunctive treatment option for invasive infections in some neutropenic patients with underlying hematologic malignancy (HM). Patients and methods: We sought to determine the impact of GTX as an adjunct to antifungal therapy in 128 patients with HM and prolonged neutropenia (>14 days) with a proven or probable invasive aspergillosis (IA) infection by retrospectively reviewing our institutional database. Results: Fifty-three patients received GTX and 75 did not. By univariate analysis, patients with invasive pulmonary aspergillosis who received GTX were less likely to respond to antifungal therapy (P = 0.03), and more likely to die of IA (P = 0.009) when compared with the non-GTX group. Among patients who received GTX, 53% developed a pulmonary reaction. Furthermore, IA-related death was associated with the number of GTX given (P = 0.018) and the early initiation of GTX within 7 days after starting antifungal therapy (P = 0.001). By multivariate competing risk analysis, patients who received GTX were more likely to die of IA than patients who did not receive GTX (P = 0.011). Conclusions: Our study suggests that GTX does not improve response to antifungal therapy and is associated with worse outcomes of IA infection in HM patients, particularly those with pulmonary involvement.

AB - Background: Granulocyte transfusions (GTXs) have been used successfully as an adjunctive treatment option for invasive infections in some neutropenic patients with underlying hematologic malignancy (HM). Patients and methods: We sought to determine the impact of GTX as an adjunct to antifungal therapy in 128 patients with HM and prolonged neutropenia (>14 days) with a proven or probable invasive aspergillosis (IA) infection by retrospectively reviewing our institutional database. Results: Fifty-three patients received GTX and 75 did not. By univariate analysis, patients with invasive pulmonary aspergillosis who received GTX were less likely to respond to antifungal therapy (P = 0.03), and more likely to die of IA (P = 0.009) when compared with the non-GTX group. Among patients who received GTX, 53% developed a pulmonary reaction. Furthermore, IA-related death was associated with the number of GTX given (P = 0.018) and the early initiation of GTX within 7 days after starting antifungal therapy (P = 0.001). By multivariate competing risk analysis, patients who received GTX were more likely to die of IA than patients who did not receive GTX (P = 0.011). Conclusions: Our study suggests that GTX does not improve response to antifungal therapy and is associated with worse outcomes of IA infection in HM patients, particularly those with pulmonary involvement.

KW - Aspergillosis

KW - Granulocyte transfusions

KW - Hematologic malignancy

UR - http://www.scopus.com/inward/record.url?scp=84883760516&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84883760516&partnerID=8YFLogxK

U2 - 10.1093/annonc/mdt110

DO - 10.1093/annonc/mdt110

M3 - Article

C2 - 23519997

AN - SCOPUS:84883760516

VL - 24

SP - 1873

EP - 1879

JO - Annals of Oncology

JF - Annals of Oncology

SN - 0923-7534

IS - 7

M1 - mdt110

ER -