Dialyzable Leukocyte Extract (Transferon™) Administration in Sepsis: Experience from a Single Referral Pediatric Intensive Care Unit
Authors: Ivonne Maciel Arciniega Martínez
Aldo Arturo Reséndiz-Albor
Maria Laura Laue Noguera
Mario A Ynga-Durand
Vanessa Ivonne Orellana-Villazon
Maria Isabel Castrejón Vázquez
Maria Eugenia Vargas Camaño
Carlos Alberto García López
Journal: BioMed Research International (2019)
Discipline: BIOLOGY & BIOCHEMISTRY
Keywords: Immunomodulatory agents; Transferon™; sepsis; pediatric intensive care unit (PICU); C reactive protein (CRP)
Affiliations: Department of Clinical Immunology and Allergy, Centro Médico Nacional "20 de Noviembre," Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico., Laboratorio de Inmunidad de Mucosas, Sección de Investigación y Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico., Sección de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico., Department of Pediatric Intensive Care Medicine, Centro Médico Nacional "20 de Noviembre," Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico City, Mexico.

Abstract:  Immunomodulatory agents have been proposed as therapeutic candidates to improve outcomes in sepsis. Transferon™, a dialyzable leukocyte extract (DLE), has been supported in Mexico as an immunomodulatory adjuvant in anti-infectious therapy. Here we present a retrospective study describing the experience of a referral pediatric intensive care unit (PICU) with Transferon™ in sepsis. We studied clinical and laboratory data from 123 patients with sepsis (15 in the DLE group and 108 in the control group) that were admitted to PICU during the period between January 2010 and December 2016. Transferon™ DLE use was associated with lower C reactive protein (CRP), increase in total lymphocyte counts (TLC), and decrease in total neutrophil count (TNC) 72 hours after Transferon™ DLE administration. The control group did not present any significant difference in CRP values and had lower TLC after 72 hours of admission. There was no difference in PICU length of stay between control and Transferon™ DLE group. Transferon™ DLE administration was associated with a higher survival rate at the end of PICU stay. This study shows a possible immunomodulatory effect of Transferon™ on pediatric sepsis patients. 

Retracted: No

PubPeer comments:
 The differences in neutrophil count between the groups are very relevant. Neutropenia is a well known factor of poor prognosis in pediatric sepsis. Vila Pu00e9rez D, Jordan I, Esteban E, Garcu00eda-Soler P, Murga V, Bonil V, Ortiz I, Flores C, Bustinza A, Cambra FJ. Prognostic factors in pediatric sepsis study,from the Spanish Society of Pediatric Intensive Care. Pediatr Infect Dis J. 2014 Feb;33(2):152-7. PMID 24413407 https: www.ncbi.nlm.nih.gov pubmed 24413407 Neutropenia is defined as a neutrophil count of less than 2000 uL . Judging from the data in the last row of Table 1, a majority of the 15 subjects in the treatment group had neutrophil counts that did not constitute neutropenia. In contrast, many of the subjects in the control group must have had levels of neutrophils below 2000, so they were neutropenic. The differences in outcome might well be the result of these differences and had nothing to do with receiving the investigation product. Authors fail to address this. ,