Pulmonary reactions can occur in these patients, but true transfusion reactions often are difficult to distinguish from other causes. Although a high incidence of severe pulmonary reactions has been reported in patients receiving granulocyte transfusions with amphotericin B, several investigators failed to confirm this phenomenon. It remains common practice to separate the administration of amphotericin from granulocytes by several hours. G-CSF donor stimulation has been studied by several investigators. Granulocytes obtained from these donors are functionally normal and may have improved phagocytic, bactericidal, and fungicidal activity.
Most donors experience mild to moderate bone aching, headache, or insomnia.
Unlike traditional granulocyte therapy, neutrophil increments in patients receiving these increased doses of cells are quite large, and intravascular survival is prolonged. In most, the majority of patients were said to respond, including those with fungal infection. Controlled trials have not been done. More severe pulmonary reactions are observed rarely. Thus, administering G-CSF to donors, particularly with corticosteroids, permits the collection of large numbers of granulocytes.