Dear Dharmesh

Universal leucodepletion is recommended to minimise the risk of transmission of certain infections that are associated with leucocytes. It was originally introduced in the UK to reduce the theoretical risk of transmission of vCJD (prion protein is expressed on leucocytes). Whether this policy is rational or not, this practice has one benefit-reduction in the incidence of febrile transfusion reactions.

Having said that, granulocyte infusion does have a place in the management of severe life threatening bacterial/fungal infection in neutropenic sepsis. We have recently given this treatment to two patients (both acute leukaemic patients post chemotherapy) with severe sepsis who were not responding to GCSF and multiple antibiotics and antifungals. Both patients made good recovery. Granulocyte infusions can 'buy time' until marrow recovery.

Hope that answers your question

Siva

1). Neutropenia and documented refractory bacterial & fungal infection, not responding to antimicrobial therapy for more than 24 to 48 hrs may be considered  for  granulocyte transfusion if the neutropenia is due to reversible myeloid hypoplasia.

2). Congenital neutrophil defects I e. Chronic granulomatous disease , not responding to appropriate antimicrobial therapy is considered for granulocyte transfusion.

Thanks 

Muttuswamy Sivakumaran & Anita for valuable feed