Значение трансфузии гранулоцитов при острых миелоидных лейкозах у детей

,3 , E.V. Flejcshman 2 , 1 , L.U. Grivtsiva 3 , 1 SUMMARY Acute myeloid leukemia (AML) is a disease where severe neutropenia after induction therapy is common and contributes to high morbidity and mortality in some cases. Thus granulocyte transfusion (GT) from healthy family donor (father, mother) can help to overcome fatal infection in patients with AML. We conducted a prospective study of 36 newly diagnosed AML patients (age 2 months — 16 years) after induction chemotherapy divided in two groups. First 12 pts had GT with antimicrobial drugs, other 24 pts received only antimicrobial therapy. Patients of the first group had severe refractory infections: 6 (50 %) pneumonia; pneumonia and blood culture positive — 2 (17 %); pneumonia and intestinal lesion 1 (8 %); cellulite — 1 (8 %); fungal lesion of hepar —1(8 %) and 1 (8 %) had febrile fever. In the second group 15 (63 %) pts had febrile neutropenia; pneumonia — 4 (17 %); pneumonia and intestinal lesion — 1 (4 %), enterocolitis — 2 (8 %), sepsis — 1 (4 %), cellulites — 1 (4 %). The dose of GT was 0,8–2,81  10 9 /kg. There were no any significant difference between groups according to FAB, sex and age. In the first group (GT) 8 pts (67 %) are alive (median follow up 18,8 mo); one (8 %) pt died from infection, 3 (25 %) pts had progression/relapse. In the second group 15 (63 %) pts are alive (median follow up 28,9 mo); 9 (37 %) pts died from progression or relapse. Median neutrophil recovery in the first group was 34,3  3,1 days, duration of neutropenia in the second was 31,8  1,9 days. Thus, the GT was quiet tolerable and can be suggested as an additional treatment of severe infections in patients with prolonged aplasia who do not respond to antimicrobial therapy. Preliminary data reveal a trend to better DFS in GT group though the results were not statistically significant. The study will be continued.