2018年11月，吴德沛教授课题组在《annals of hematology》发表题为“Clinical outcome of granulocytetransfusion therapy for the treatment of refractory infection in neutropenicpatients with hematological diseases”的研究论文，总结了中性粒细胞输注治疗在血液病患者中的应用。该文的第一作者为三年级硕士生周必琪，通讯作者为吴德沛教授、徐杨副教授。
中性粒细胞输注(GTX)用于治疗血液病患者在粒缺期易出现的重症感染，一直以来被认为是一种合理的治疗方式。然而，关于它的疗效和不良反应报导甚少。我们总结了2009至2015年间47例共输注117次中性粒细胞治疗重症感染的血液病患者的疗效，发现GTX是粒缺期重症感染的血液病患者血象恢复前可使用的一种有效的支持治疗方式，尤其对肺部感染效果较好。GTX治疗后10天内粒系重建者细菌感染的转归及总体生存率较好，而疾病状态、输注开始时间和剂量对于总体疗效并无显著差异。另外，对于接受造血干细胞移植(HSCT)的血液病患者而言，GTX治疗不会增加患者GVHD和CMV感染的概率。
原文摘要：Neutropenic patients with hematological diseases areprone to severe infections. Granulocyte transfusion therapy (GTX) is consideredas a logical therapeutic approach for these problems. However, the efficacy andcomplications of GTX have not been well identified. We retrospectively analyzedthe clinical outcomes of GTX therapy in our hospital from 2009 to 2015. After117 granulocyte transfusions for 47 patients, 72.3% of these patients’infections were effectively improved, and the overall survival rates at 30 daysand 120 days were 66.0% and 57.5%, respectively. The patients who experiencedneutrophil recovery within 10 days after their therapy initiation had a betterresponse and long term survival period (14/15, 93.3% vs 20/32, 62.5%, P=0.037).Higher-dose granulocytes (﹥2.55×108/kg ) might improvethe effective rate of infection in the patients who had more than 10 days neutrophilrecovery time (17/23, 73.9% vs 3/9, 33.3%, P=0.049). In addition, GTX benefitedthe patients who suffered from pulmonary bacterialinfections (16/20, 80%) compared with the bloodstream infection group (7/12, 58.3%) and skin or mucous infection group (1/5, 20%). The primarydata showed that GTX did not affect the incidence of graft-versus-host disease(GVHD) and cytomegalovirus viremia when patients received further HSCTtreatment. Collectively, GTX was an adjunct treatmentmodality for severely neutropenic patients who were likely to experiencehematopoietic recovery. More randomized trials are needed to verifythe efficacy and complications of GTX therapy.
