Blood Bank Guy Essentials Podcast 064CE: Granulocyte Transfusion with Ron Strauss
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Feb 27, 2019 Join Dr. Ron Strauss, a seasoned pediatrician and expert in hematology oncology, as he dives into the sometimes overlooked world of granulocyte transfusions. He discusses the evolving landscape of this practice, citing modern trials that suggest high-dose granulocyte concentrates could yield better outcomes. Dr. Strauss sheds light on the challenges surrounding donor safety and compatibility, while addressing fears about GCSF usage. With a historical perspective and promising future insights, he emphasizes the critical role granulocyte transfusions play in treating infections in leukemia patients.
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Early Apheresis Was Cumbersome
- Early granulocyte collection used giant consoles with 64 feet of tubing and many stopcocks that took hours to set up.
- Ron Strauss recounts operating those machines and explains how inefficient early collections were compared to modern separators.
Dose Drives Observed Efficacy
- Early randomized trials produced mixed results partly because granulocyte doses were low and inconsistent.
- Higher dose transfusions in trials tended to correlate with better outcomes, suggesting dose matters more than presence alone.
RING Trial Design Aimed For High Dose
- The RING trial randomized neutropenic patients to antibiotics alone or antibiotics plus daily granulocytes stimulated with GCSF and dexamethasone.
- The trial aimed for ≥4x10^10 granulocytes per transfusion and used an independent adjudication committee to assess outcomes.