BACKGROUND: Granulocyte transfusion therapy has been used as supportive care for patients with prolonged neutropenia after intensive chemotherapy or peripheral blood stem cell transplantation (PBSCT). Here, we investigated clinical factors of granulocyte transfusion therapy for neutropenic patients with infection to evaluate its efficacy and safety. METHODS: A retrospective analysis of 25 neutropenic patients treated with 99 granulocyte collection and granulocyte transfusion therapy from October 2011 to April 2016 at the National Cancer Center was conducted. Two groups, a count recovery group with a cut off of >1,000/µL and a no recovery group were compared and symptoms related with granulocyte transfusion were analyzed. RESULTS: Granulocyte collection and transfusions were performed in 99 procedures. After granulocyte transfusion therapy, 21 patients (84%) showed count recovery, whereas 4 patients (16%) had no response. Significant differences in pre-absolute neutrophil count (29/µL vs. 0/µL, P=0.048), duration of neutropenia before granulocyte transfusion (11 days vs. 26 days, P=0.011), and total number of granulocyte transfusion (2 times vs. 11 times, P=0.049) were observed between groups. Temporary symptoms related granulocyte transfusion were observed in seven patients (28%); however, all patients showed clinical improvement. The median of the single transfusion volume was 220 mL (200 to 397 mL) and the mean total granulocyte content was 4.92×10¹⁰. CONCLUSION: Granulocyte transfusion therapy is safe and effective for patient with life threatening neutropenia and infection, also considerable for early onset trial for granulocyte transfusion.
Drug Therapy ; Granulocytes* ; Humans ; Leukocyte Transfusion ; Neutropenia* ; Neutrophils ; Peripheral Blood Stem Cell Transplantation ; Retrospective Studies

OBJECTIVE: Amifostine (Ethyol(R)), an organic thiophosphate, has shown the ability to protect normal, but not neoplastic, tissues from the damaging effects of chemotherapy and radiotherapy in various kinds of cancers. This study was designed to determine ifostine could reduce the serious hematologic and nephrologic toxicities associated with cisplatin based combination chemotherapy in gynecologic cancer patients. PATIENTS AND METHODS: Forty patients who received cisplatin-based combination chemotherapy were randomized into two groups. They received chemotherapy with or without pretreatment of amifostine before each course. The occurrence of hematologic and renal toxicities were evaluated. Stastical analysis was done by independent t-test and Chi-square test. RESULTS: Hematologic toxicity was evaluated with nadir count of neutrophil and platelet. The nadir count of neutrophil was 2034.2+/-1199.20/microliter in group with pretreatment using amifostine vs 1070.85+/-472.66/microliter in control group (p<0.01). Platelet count was not statistically different. (p<0.16) Grade 3 neutropenia was observed in nine (45%) patients in pretreatment group vs four (20%) patients with control group (p<0.09). Grade 4 neutropenia occurred in one patient only in control group. Renal toxicity was evaluated by serum creatinine and creatinine clearance. Protracted serum creatinine elevation was not significant in both groups. (p<0.14) Reduction of creatinine clearance was less in patients with pretreatment (p<0.01). There were no significant side reactions in subjects using amifostine. CONCLUSION: Pretreatment with amifostine reduces the neutropenia and nephrotoxicity associated with cisplatin-based combination chemotherapy with gynecologic cancer patients.
Amifostine* ; Blood Platelets ; Cisplatin ; Creatinine ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Neutropenia ; Neutrophils ; Platelet Count ; Radiotherapy

OBJECTIVE: Amifostine (Ethyol(R)), an organic thiophosphate, has shown the ability to protect normal, but not neoplastic, tissues from the damaging effects of chemotherapy and radiotherapy in various kinds of cancers. This study was designed to determine ifostine could reduce the serious hematologic and nephrologic toxicities associated with cisplatin based combination chemotherapy in gynecologic cancer patients. PATIENTS AND METHODS: Forty patients who received cisplatin-based combination chemotherapy were randomized into two groups. They received chemotherapy with or without pretreatment of amifostine before each course. The occurrence of hematologic and renal toxicities were evaluated. Stastical analysis was done by independent t-test and Chi-square test. RESULTS: Hematologic toxicity was evaluated with nadir count of neutrophil and platelet. The nadir count of neutrophil was 2034.2+/-1199.20/microliter in group with pretreatment using amifostine vs 1070.85+/-472.66/microliter in control group (p<0.01). Platelet count was not statistically different. (p<0.16) Grade 3 neutropenia was observed in nine (45%) patients in pretreatment group vs four (20%) patients with control group (p<0.09). Grade 4 neutropenia occurred in one patient only in control group. Renal toxicity was evaluated by serum creatinine and creatinine clearance. Protracted serum creatinine elevation was not significant in both groups. (p<0.14) Reduction of creatinine clearance was less in patients with pretreatment (p<0.01). There were no significant side reactions in subjects using amifostine. CONCLUSION: Pretreatment with amifostine reduces the neutropenia and nephrotoxicity associated with cisplatin-based combination chemotherapy with gynecologic cancer patients.
Amifostine* ; Blood Platelets ; Cisplatin ; Creatinine ; Drug Therapy ; Drug Therapy, Combination* ; Humans ; Neutropenia ; Neutrophils ; Platelet Count ; Radiotherapy

Classical cyclic neutropenia is the most frequent of the cyclic hematopoietic disorders and a rare condition characterized by regular and predictable oscillations in the peripheral neutophil counts with the cycle length varying from 14 to 28 days and in many cases simultaneous fluctuation in the other blood cell line. The etiology of cyclic neutropenia is unknown, but has usually been considered as stem-cell disorder. We have observed a 17-year-old boy with a cyclic pancytopenia with a constant and predictable oscillation period of about 120 days. Serial bone marrow biopsies showed a similar fluctuating pattern and myelodysplatic change. We report this case and review the literature regarding this unusal long period cyclic neutropenia.
Adolescent ; Biopsy ; Blood Cells ; Bone Marrow ; Hematopoiesis* ; Humans ; Male ; Neutropenia ; Pancytopenia

To investigate the serum granulocyte colony-stimulating factor (G-CSF) level in patients with chronic idiopathic neutropenia (CIN) and analyze its clinical significance. By the use of G-CSF-specific enzyme-linked immunosorbent assay (ELISA), the serum levels of G-CSF were determined in 40 cases with chronic CIN, 40 cases with systemic lupus erythematosus (SLE) complicated neutropenia and 40 healthy volunteer (normal control). Results showed that serum G-CSF was positive in 11 normal controls and in 10 cases with SLE, and the G-CSF levels were (27.34 +/- 8.00) ng/L and (26.76 +/- 7.26) ng/L, respectively. Serum G-CSF in 27 cases with CIN was positive, the level was (134.04 +/- 89.29) ng/L, which was higher than that in the normal controls and the cases with SLE (P < 0.01). It was concluded that an obstacle to utilization of G-CSF could be existed in the patients with CIN.
Adolescent ; Adult ; Chronic Disease ; Enzyme-Linked Immunosorbent Assay ; Female ; Granulocyte Colony-Stimulating Factor ; blood ; Humans ; Male ; Middle Aged ; Neutropenia ; blood

We analyzed the comparative amounts of granulocyte-colony stimulating factor (G-CSFr) and granulocyte macrophage CSF (GM-CSFr) receptors expressed on neutrophils and monocytes in measles patients to investigate the role of these CSFrs in the development of leukopenia including neutropenia and monocytopenia in measles. EDTA-anticoagulated peripheral blood of 19 measles patients, 10 children with other infections showing leukopenia and 16 children with normal complete blood cell counts (CBC)s were analyzed using flow cytometry and QuantiBRITE. The leukocyte (5260 +/- 2030/uL vs. 9900 + 2680/uL, p=0.000), neutrophil (2580 +/- 960/uL vs. 4250 +/- 2750/uL, p=0.024) and the lymphocyte counts of measles patients (1810 +/- 1430/uL vs. 4530 +/- 3450/uL, p= 0.006) were lower than in the normal controls. The neutrophils of measles patients expressed similar amounts of G- CSFr (1858 +/- 355) as normal children (1764 +/- 477, p= 0.564) and leukopenic patients (1773 +/- 673, p=0.713), but lower levels of GM-CSFr (535 +/- 118) than normal children (957 +/- 344, p=0.000) and leukopenic patients (832 +/- 294, p=0.002). The monocytes of measles patients expressed similar amounts of G-CSFr (916 +/- 336) and GM-CSFr (3718 +/- 906) as normal children (1013 +/- 391 and 4125 (2645, p > 0.05) but less than leukopenic patients (1454 +/- 398 and 5388 +/- 806, p > 0.05). The neutrophil and monocyte counts of measles patients did not correlate with the amount of G-CSFr or GM-CSFr expressed on neutrophils or monocytes (p > 0.05), but in the normal children, the monocyte count correlated with the levels of GM-CSFr on monocytes (r=0.951, p=0.049). In conclusion, neutropenia is one of the more important characteristics of measles patients, which could be due to the decreased GM-CSFr expression on neutrophils. However, the monocytopenia found in measles patients is not due to the decreased expression of CSFr on the monocytes.
Human ; Leukocyte Count ; Measles/*blood ; Monocytes/*chemistry ; Neutropenia/etiology ; Neutrophils/*chemistry ; Receptors, Granulocyte Colony-Stimulating Factor/*blood ; Receptors, Granulocyte-Macrophage Colony-Stimulating Factor/*blood

This study was carried out to evaluate the diagnosis of acute clinical mastitis (ACM) which was based on the vital signs and complete blood count (CBC) tests in dairy cows. Twenty eight dairy cows diagnosed with ACM, were selected for the study between Jan 2003 and July 2006 in the National Institute of Animal Science. Based on their vital signs (rectal temperature, depression, rumen contraction and, dehydration status), ACM was divided into three different classes; mild, moderate and severe forms. In addition, ACM cows were subjected to CBC tests for further diagnosis of ACM. Of the 27 dairy cows diagnosed with ACM, 3 cows were determined to have a mild form, while moderate and sever forms were each observed in twelve cows. Among of them, 4 cows died, 5 cows were culled and 18 cows were recovered. In the mild form, all haematological parameters were comparable with normal values. However, leukopenia, due to neutropenia and lymphocytopenia, appeared characteristically in the moderate and severe forms. Using the observation of vital signs in conjunction with CBC tests, the diagnosis of ACM is more accurate, and is helpful in making decisions of whether treatment or culling of dairy cows infected with ACM is most appropriate.
Animals ; Blood Cell Count ; Contracts ; Dehydration ; Depression ; Female ; Leukopenia ; Lymphopenia ; Mastitis ; Neutropenia ; Reference Values ; Rumen ; Vital Signs

Prolonged administration of steroid in children with steroid-dependent nephrotic syndrome can cause serious complications including growth failure, and various alternative treatments have been used for these children to alleviate steroid-induced complications and to achieve long-lasting remission. Present study was undertaken to compare the therapeutic efficacy of cytotoxic agents (cyclophosphamide and chlorambucil), cyclosporine and levamisole in 88 children with steroid-dependent mininal-change nephrotic syndrome, who have been followed-up in Pediatric Department, Kyungpook National University Hospital from 1985 to 1995. Cyclophosphamide and chlorambucil were given for 8 weeks (cyclophosphamide in 36 and chlorambucil in 13 cases) or 12 weeks (cyclophosphamide in 34 and chlorambucil in 12 cases), and cyclosporine (3-5mg/kg/day) and levamisole (2-2.5mg/kg alternate day) were given for 6-12 months. And the results were as follows ; Results of cytotoxic therapy ; At the end of the 1st year, remission rate with 12 wks course of cyclophosphamide(53%) was better than with 12 wks course of chlorambucil(33%) or 8 wks course of either drugs. However, at the end of the 2nd year, no difference was noted in remission rate between 12 wk course of cyclophosphamide(19%) and chlorambucil(17%). Results of cyclosporine therapy ; Out of 44 cases, 28(64%) showed sustain-ed remission, 8(18%) relapse with decreased frequency and steroid-sparing effect, and 8 no therapeutic effects. During treatment period, BUN, creatinine and blood pressure were remained in normal ranges. Remission rates with cyclosporine alone therapy without steroid in cyclosporine-responsive children were 83%, 83%, 57% and 43% at 2, 4, 6 and 8 months, respectively. Results of levamisole therapy ; Out of 16 cases, 8 (50%) showed sustained remission, 5(31%) relapse with decreased frequency and steroid-sparing effect, and 3 no therapeutic effects. In one case, transient neutropenia was observed without serious sequelae. Remission rate with levamisole alone therapy without steroid in levamisole-responsive children were 88%, 85%, 67% and 44% at 2, 4, 6 and 8 months, respectively. In conclusion, present study indicates that 12 weeks course of cyclohospha-mide or chlorambucil seems to be the most effective therapy for inducing long-lasting remission in steroid-dependent nephrotic children. And long-term use of cyclosporine or levamisole can also be used quite effectively in achieving prolonged remission and steroid-sparing effects without serious side effects.
Blood Pressure ; Child* ; Chlorambucil ; Creatinine ; Cyclophosphamide ; Cyclosporine* ; Cytotoxins* ; Gyeongsangbuk-do ; Humans ; Levamisole* ; Nephrotic Syndrome* ; Neutropenia ; Recurrence ; Reference Values

Neutropenia is defined as an absolute neutrophil count (ANC) of <1,500/microliter, and the severity of neutropenia generally can be graded as mild (1,000-1,500/microliter), moderate (500-1,000/microliter), or severe (<500/microliter). This stratification aids in predicting the risk of pyogenic infection because the susceptibility to life-threatening infections is significantly increased in patients with prolonged episodes of severe neutropenia. Especially cancer-related neutropenia carry significant mortality. Neutropenia can develop under various conditions such as decreased bone marrow production, the sequestering of neutrophils, and increased destruction of neutrophils in the peripheral blood. Neutropenia is classified according to the etiology as congenital or acquired, with the latter further defined according to the etiology or pathology. The clinical result is increased risk for infection, which is directly proportional to the severity and duration of the neutropenia. The typical workup of neutropenia starts with a 6-week period in which complete blood counts are measured twice weekly to document the persistence of the neutropenia and whether a cyclic pattern is present. When persistent neutropenia is diagnosed and no spontaneous recovery occurs within 3 months, a more extensive evaluation is advised. Treatment is usually unnecessary for most patients with severe neutropenia, as the majority of patients have a good prognosis. However, for patients who have severe and frequent infections, treatment with filgrastim may prevent infectious complications and improve quality of life.
Blood Cell Count ; Bone Marrow ; Child ; Granulocyte Colony-Stimulating Factor ; Humans ; Neutropenia ; Neutrophils ; Prognosis ; Quality of Life ; Recombinant Proteins ; Filgrastim

PURPOSE: Febrile neutropenia (FN) still remains a life-threatening cancer treatment-related toxicity and may compromise further chemotherapy in individual cancer patients. In this study, we sought to determine predictors of bacteremia in cancer patients with FN at the time of their visiting the emergency department. METHODS: Between January 1, 2007 and December 31, 2008, 392 episodes of FN in 342 cancer patients were retrospectively reviewed. We assessed clinical and laboratory features, and MASCC risk-index scores at admission to the emergency department. Statistical analysis was done using SPSS ver. 11.0. RESULTS: Among a total of 392 episodes, 34 (8.7%) showed bacteremia. There was a significant difference between bacteremic episodes and non-bacteremic episodes in tachycardia (56% vs. 31%), tachypnea (24% vs. 8%), high temperature (36% vs. 16%), hemoglobin (9.4 vs. 10.1 g/dL), platelet (73.3 vs. 117.5 x 10(3)/mm3), BUN (24 vs. 13 mg/dL), creatinine (1.2 vs. 0.8 mg/dL), and CRP (12.6 vs. 8.5 mg/dL). On multivariate analysis, low platelet count (OR 5.6, 95% CI 2.5-12.5, p<0.001), elevated BUN (OR 4.8, 95% CI 2.1-11.0, p<0.001), tachypnea (OR 3.2, 95% CI 1.2-8.3, p=0.020), and high temperature (OR 2.7, 95% CI 1.2-6.2, p=0.019) were independent factors associated with bacteremia. MASCC score < 21 was more frequent in bacteremic than non-bacteremic patients (32% vs. 10%, p=0.001). CONCLUSION: Low platelet count, elevated BUN, tachypnea, and high temperature are independent predictors of bacteremia in cancer patients with FN. Also, the MASCC risk-index score is a useful predictor of bacteremia.
Bacteremia ; Blood Platelets ; Creatinine ; Emergencies ; Fever ; Hemoglobins ; Humans ; Multivariate Analysis ; Neutropenia ; Platelet Count ; Retrospective Studies ; Tachycardia ; Tachypnea