Comparative Study of Radiated and Unradiated Leukocyte Transfusions for Patients With Life-threatening Infections: A Collaborative Study by the Leukemia Department and Laboratory Medicine
Radiated White Blood Cell Transfusions:
White blood cell transfusions from a volunteer donor may contain blood cells that your body
can react with to produce a disorder called transfusion-associated graft versus host
disease. This means that some of the injected white blood cells can reproduce in your body
and react with your own tissues and create side effects. To avoid this, the blood is
radiated (changed through radiation) to kill all the cells that can divide. But this
radiation also may destroy some of the infection-fighting capacity of the white blood cell
transfusion, this may decrease the effectiveness of these white blood cell transfusions.
Radiating white blood cells is the standard procedure that has been used to treat serious,
Non-Radiated White Blood Cell Transfusions:
If the white blood cells are not radiated, it may increase the effectiveness of these white
cell transfusions. This may help the white blood cells to make more infection-fighting
white blood cells. But, the cells that are also responsible for the transfusion-associated
graft versus host disease will not be killed. This increases the risk that you could have
If you agree to take part in this study, and if you are one of the first 40 patients, you
will be randomly assigned (as in the flip of a coin) to 1 of 2 groups. You or your
physician will not know the results of this randomization. If you are in Group 1, you will
have a non-radiated white blood cell transfusion. If you are in Group 2, you will have a
standard white blood cell transfusion (with radiation). If you are less than 50 years old,
you will receive 4 transfusions of radiated white cells. If you continue to show signs and
symptoms of infection you will receive additional white cell transfusions based on the group
you were randomized to.
If you are after the first 40 patients, you will be placed in a group that the study doctor
thinks will most benefit you. It is important to note that this study is designed as a
"adaptive randomization" which means that as the outcome for each individual is observed,
the next patient receives the product which is most likely to be beneficial and least likely
to be harmful.
White Blood Cell Transfusion:
Before the transfusion, a nurse will take your temperature, breathing rate and blood
pressure. During the transfusion a nurse will watch you closely. Side effects sometimes
occur during and soon after the transfusion. You may be given a drug to help or reduce any
If you are in Group 2, you will receive 4 standard white blood cell transfusions (with
If you still have an infection after 4 transfusions and the doctor thinks it is necessary,
you will have additional transfusions. You will continue to have transfusions until the
doctor feels the infection has been controlled. If you experience GVHD, this will be up to
your doctor's discretion.
If you need a white blood cell transfusion for a new infection or for an infection that
comes back, you will receive the same type of transfusion as you received before.
If you were discharged from the hospital and your doctor would like for you to continue
receiving white blood cell transfusions, you will be able to receive them as an outpatient.
Each transfusion will take from 1 hour to several hours depending on how you tolerate the
treatment. Each transfusion will be given daily or as close to daily as possible.
Before every infusion, blood (about 1 tablespoon) will be drawn to measure the number of
white blood cells in your blood.
Length of Study:
You will receive transfusions until your doctor feels the infection has been controlled.
This is an investigational study. White blood cell transfusions are considered standard
procedure for the treatment of serious, life threatening infections.
Up to 150 patients will take part in this study. All will be enrolled at M. D. Anderson.
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
30-Day Survival Rate
Participant survival measured over the 30 days subsequent to the first granulocyte transfusion. Collecting complete blood counts (CBCs) pre and post transfusion allows determination of whether the duration of neutrophil replacement differs between the two study groups (comparing unradiated white blood cells to radiated white blood cell infusion).
Emil J Freireich, MD, BS
UT MD Anderson Cancer Center
United States: Institutional Review Board
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