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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.

Author information

1
a SSD Trapianto Cellule Staminali, A.O.U. Citta' della Salute , Torino , Italy.
2
b Pediatric Hematology Oncology , Azienda Ospedaliera Universitaria Integrata Verona , Italy.
3
c Department of Onco-Hematology , Fondazione Policlinico Universitario A. Gemelli-Università Cattolica del Sacro Cuore , Rome , Italy.
4
d Dipartimento dell'Emergenza e dei Trapianti Di Organo , U.O Ematologia con Trapianto - Azienda Ospedaliero-Universitaria - Policlinico di Bari , Italy.
5
e Hematology, Spedali Civili , Brescia , Italy.
6
f Hematology and Stem Cell Transplant Unit Regina Elena National Cancer Institute , Rome , Italy.
7
g Hematology, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico , Milano , Italy.
8
h Unità di ematologia e trapianti di midollo osseo, IRCCS San Raffaele , Milano , Italy.
9
i Hematology , University of Parma , Italy.
10
j Clinica Ematologica, Centro Trapianti e Terapie Cellulari , Azienda Sanitaria Universitaria Integrata di Udine , Italy.
11
k Hematology , University of Rome "Tor Vergata" , Italy.
12
l Ematologia adulti e CTA ASST Monza , Universita' Milano Bicocca, Ospedale San Gerardo , Monza , Italy.
13
m Hematology , ASST Grande Ospedale Metropolitano Niguarda , Milano . Italy.

Abstract

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.

KEYWORDS:

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

PMID:
29285951
DOI:
10.1080/17474086.2018.1420472
[Indexed for MEDLINE]

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