Granulocytes are obtained through apheresis from a single donor stimulated with a corticosteroid*. The objective is to obtain a quantity of at least 1 x 1010 granulocytes. The bag contains an average of 32 ± 8 mL (24 to 40 mL) of red blood cells and a variable number of lymphocytes and platelets in plasma.

Hydroxyethyl starch at a 6% concentration* is used to facilitate the collecting of the granulocytes. A 46.7% trisodium citrate solution diluted in 500 mL of hydroxyethyl starch at a 6% concentration is used for collecting the granulocytes. About 36 mL of hydroxyethyl starch at a 6% concentration and 2 mL of 46.7% citrate are present in the final product.

* The corticosteroid and the hydroxyethyl starch at a 6% concentration are not registered for this use in Canada.

Action

The granulocytes phagocytize the bacteria and fungi.

An increase in the number of granulocytes is rarely seen in a recipient after a granulocyte transfusion. This is usually attributed to consumption of the granulocytes at the site of the infectious process.

Main indications

Granulocytes are mainly indicated as supportive therapy in recipients with severe neutropenia (usually less than 0.5 x 109 /l) and a documented severe bacterial or fungal infection that is unresponsive to appropriate antimicrobial or antifungal treatments. The effectiveness of granulocyte transfusions in various clinical situations has not been demonstrated. This product is not recommended for prophylactic treatment of infection.

Granulocytes intended for recipients who are seronegative for CMV and immunocompromised should be collected from donors who are seronegative for CMV.

To prevent graft-versus-host disease, the granulocytes are always irradiated.

Contraindications

Recipients with anti-HLA or anti-neutrophil antibodies may not fully benefit from a granulocyte transfusion and have a higher risk of complications.

Dosage and administration

Granulocytes contain a significant number of red blood cells, and bidirectional compatibility tests (major and minor) must be conducted.

Granulocytes should be transfused as soon as possible after collection using a standard infusion set. Leukocyte depletion filters trap granulocytes and must not be used in the transfusion of this component.

Storage

The product must be stored without agitation between 20°C and 24°C for no more than 24 hours.

In the event of a discrepancy between the information on this page and what is in the Circular of information, the latter will take precedence.