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<p>Introduction: Sepsis in acute myeloid leukemia (AML) induction remains a leading cause of morbidity and mortality. This study aimed to evaluate the impact of prophylactic buffy coat–derived granulocyte transfusions in AML induction. Methods: This ambispective, single-center study included newly diagnosed AML patients aged &gt; 18 years who underwent intensive chemotherapy and received prophylactic buffy coat–derived granulocyte transfusions from October 2021 to October 2023. Primary endpoints included ICU admissions, ICU and hospital stay duration, and transfusion support requirements (PRBCs, RDPs, and SDPs). Secondary endpoints included transfusion-related adverse events, duration of antibiotic therapy, and infection-related mortality. Outcomes were compared with matched historical controls. Results: Fifty-one patients (<i>n</i> = 51) received prophylactic granulocyte transfusions and were compared with 51 controls. The median age was 41 years (range 20–58) versus 40 years (18–67). Granulocyte transfusions were given for a median of 5 days (range 1–13), with a median of 30 units per patient (range 6–71). Primary prophylaxis accounted for 78.4% of cases. Adverse events included febrile non-hemolytic transfusion reactions (31.4%), allergic reactions (1.9%), and pulmonary complications (1.9%). ICU admission occurred in 12.8% versus 9.8% (<i>p</i> = 0.2), and a hospital stay of 26 vs. 24 days (<i>p</i> = 0.08). Transfusion requirements were lower in the granulocyte group (PRBC 4 vs. 8 units, RDP 12 vs. 18, SDP 0 vs. 2; p &lt; &lt; 0.01 for each group). Infection-associated mortality was similar (3.9% in each group). Conclusion: Prophylactic transfusion of buffy coat–derived granulocytes reduced red cell and platelet requirements in AML induction; however, it did not significantly improve ICU stay or survival outcomes.</p>

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Prophylactic Granulocyte Transfusions in Induction Phase of Acute Myeloid Leukaemia Treatment: Lifesaving Strategy or Wishful Thinking?

  • 期刊论文

  • 发表日期：

    2026年2月16日

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  • Sundar Popat Shewale,
  • Asish Rath,
  • Debapriya Basu,
  • Saurabh Bhave,
  • Jeevan Kumar,
  • Suvro Sankha Datta,
  • Deepak Kumar Mishra,
  • Mammen Chandy,
  • Reena Nair

摘要

Introduction: Sepsis in acute myeloid leukemia (AML) induction remains a leading cause of morbidity and mortality. This study aimed to evaluate the impact of prophylactic buffy coat–derived granulocyte transfusions in AML induction. Methods: This ambispective, single-center study included newly diagnosed AML patients aged > 18 years who underwent intensive chemotherapy and received prophylactic buffy coat–derived granulocyte transfusions from October 2021 to October 2023. Primary endpoints included ICU admissions, ICU and hospital stay duration, and transfusion support requirements (PRBCs, RDPs, and SDPs). Secondary endpoints included transfusion-related adverse events, duration of antibiotic therapy, and infection-related mortality. Outcomes were compared with matched historical controls. Results: Fifty-one patients (n = 51) received prophylactic granulocyte transfusions and were compared with 51 controls. The median age was 41 years (range 20–58) versus 40 years (18–67). Granulocyte transfusions were given for a median of 5 days (range 1–13), with a median of 30 units per patient (range 6–71). Primary prophylaxis accounted for 78.4% of cases. Adverse events included febrile non-hemolytic transfusion reactions (31.4%), allergic reactions (1.9%), and pulmonary complications (1.9%). ICU admission occurred in 12.8% versus 9.8% (p = 0.2), and a hospital stay of 26 vs. 24 days (p = 0.08). Transfusion requirements were lower in the granulocyte group (PRBC 4 vs. 8 units, RDP 12 vs. 18, SDP 0 vs. 2; p < < 0.01 for each group). Infection-associated mortality was similar (3.9% in each group). Conclusion: Prophylactic transfusion of buffy coat–derived granulocytes reduced red cell and platelet requirements in AML induction; however, it did not significantly improve ICU stay or survival outcomes.