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Expert Rev Hematol. 2018 Feb;11(2):155-168. doi: 10.1080/17474086.2018.1420472. Epub 2018 Jan 3.

SEIFEM 2017: from real life to an agreement on the use of granulocyte transfusions and colony-stimulating factors for prophylaxis and treatment of infectious complications in patients with hematologic malignant disorders.

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a SSD Trapianto Cellule Staminali, A.O.U. Citta' della Salute , Torino , Italy.
b Pediatric Hematology Oncology , Azienda Ospedaliera Universitaria Integrata Verona , Italy.
c Department of Onco-Hematology , Fondazione Policlinico Universitario A. Gemelli-Università Cattolica del Sacro Cuore , Rome , Italy.
d Dipartimento dell'Emergenza e dei Trapianti Di Organo , U.O Ematologia con Trapianto - Azienda Ospedaliero-Universitaria - Policlinico di Bari , Italy.
e Hematology, Spedali Civili , Brescia , Italy.
f Hematology and Stem Cell Transplant Unit Regina Elena National Cancer Institute , Rome , Italy.
g Hematology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico , Milano , Italy.
h Unità di ematologia e trapianti di midollo osseo, IRCCS San Raffaele , Milano , Italy.
i Hematology , University of Parma , Italy.
j Clinica Ematologica, Centro Trapianti e Terapie Cellulari , Azienda Sanitaria Universitaria Integrata di Udine , Italy.
k Hematology , University of Rome "Tor Vergata" , Italy.
l Ematologia adulti e CTA ASST Monza , Universita' Milano Bicocca, Ospedale San Gerardo , Monza , Italy.
m Hematology , ASST Grande Ospedale Metropolitano Niguarda , Milano . Italy.


The rapid spread of severe infections mainly due to resistant pathogens, justifies the search for therapies aiming to restore immune functions severely compromised in patients with hematologic malignancies. Areas covered: The present review summarizes the current knowledge on the role of granulocyte transfusions and colony-stimulating factors as treatment strategy for hematologic patients with serious infectious complications. In addition, a survey among 21 hematologic centers, to evaluate the clinical practice for the use of G-CSF originator and biosimilars was performed. Expert commentary: Granulocyte transfusions with a target dose of at least 1.5-3 × 108 cells/kg, may be considered as an approach to bridge the gap between marrow suppression and recovery of granulocytes. G-CSF shortens the period of neutropenia, the hospitalization, the use of antibiotics and the rate of febrile neutropenia (FN) in adult and pediatric patients with non-Hodgkin lymphoma, and in adults with acute myeloid leukemia where these advantages nevertheless, did not translate into a clinical benefit. G-CSF biosimilar showed equivalence or non-inferiority to filgrastim. There are no data supporting the use of GM-CSF, eltrombopag and erythropoietin for preventing or treating infectious complications in patients with hematologic disorders.


Hematologic malignancies; colony-stimulating factors; granulocyte transfusions; infectious complications; invasive fungal infections

[Indexed for MEDLINE]

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