Granulocyte concentrates contain granulocytes (≥1 × 1010) that have been obtained from a single donor using apheresis and are suspended in plasma; they also contain various other cells, including other types of white blood cells, red blood cells, and platelets. A small amount of artificial colloids (hetastarch [hydroxyethyl starch] or other) is also present in the product. When necessary, granulocyte concentrate may be stored at 20 to 24 degrees Celsius for up to 24 hours from the completion of apheresis. All granulocyte transfusions require irradiation.
Granulocyte concentrates are used in rare cases of life-threatening bacterial or fungal infections in patients with prolonged agranulocytosis (neutrophil counts <500/microL) for which resolution is not expected in the short term or with abnormal granulocyte function, although their effectiveness has not been demonstrated. This product is not routinely stored in hospital blood banks. Prophylactic use of granulocyte concentrate is not recommended. Transfusions should be continued daily until bone marrow function returns or control of infection is achieved; transfusions should also be discontinued if no improvement is seen despite appropriate doses of granulocyte concentrate or if serious adverse effects occur.
Granulocyte concentrate should be administered immediately after its delivery to the ward using a standard transfusion set with a microaggregate filter. The daily dose of granulocytes in adults and children is 1.5 to 3 × 108/kg of body weight (in neonates ≥1 × 109/kg of body weight).