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Lookup NU author(s): Professor Andrew GenneryORCiD
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© 2022, This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply. Granulocyte transfusions are sometimes used as adjunctive therapy for the treatment of infection in patients with chronic granulomatous disease (CGD). However, granulocyte transfusions can be associated with a high rate of alloimmunization, and their role in CGD patients undergoing hematopoietic cell transplantation (HCT) or gene therapy (GT) is unknown. We identified 27 patients with CGD who received granulocyte transfusions pre- (within 6 months) and/or post-HCT or GT in a retrospective survey. Twelve patients received granulocyte transfusions as a bridge to cellular therapy. Six (50%) of these patients had a complete or partial response. However, six of 10 (60%) patients for whom testing was performed developed anti-HLA antibodies, and three of the patients also had severe immune-mediated cytopenia within the first 100 days post-HCT or GT. Fifteen patients received granulocyte transfusions post-HCT only. HLA antibodies were not checked for any of these 15 patients, but there were no cases of early immune-mediated cytopenia. Out of 25 patients who underwent HCT, there were 5 (20%) cases of primary graft failure. Three of the patients with primary graft failure had received granulocyte transfusions pre-HCT and were subsequently found to have anti-HLA antibodies. In this small cohort of patients with CGD, granulocyte transfusions pre-HCT or GT were associated with high rates of alloimmunization, primary graft failure, and early severe immune-mediated cytopenia post-HCT or GT. Granulocyte transfusions post-HCT do not appear to confer an increased risk of graft failure.
Author(s): Arnold DE, Chellapandian D, Parikh S, Mallhi K, Marsh RA, Heimall JR, Grossman D, Chitty-Lopez M, Murguia-Favela L, Gennery AR, Boulad F, Arbuckle E, Cowan MJ, Dvorak CC, Griffith LM, Haddad E, Kohn DB, Notarangelo LD, Pai S-Y, Puck JM, Pulsipher MA, Torgerson T, Kang EM, Malech HL, Leiding JW
Publication type: Article
Publication status: Published
Journal: Journal of Clinical Immunology
Year: 2022
Volume: 42
Pages: 1026–1035
Print publication date: 01/07/2022
Online publication date: 21/04/2022
Acceptance date: 27/03/2022
ISSN (print): 0271-9142
ISSN (electronic): 1573-2592
Publisher: Springer New York LLC
URL: https://doi.org/10.1007/s10875-022-01261-1
DOI: 10.1007/s10875-022-01261-1
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