[Problems of the chemotherapy for malignant brain tumors--treatment with granulocyte transfusion for refractory infection due to agranulocytosis].

Recent progress of the chemotherapy for malignant brain tumors has made some prolongation of survival time of the patient. However, it is still far away from our satisfactions and still we are even irritable about the results of brain tumor therapies in neurosurgical practice. One of the major side effects of these chemotherapeutic agents is myelosupression which is dose-dependent. When applying the chemotherapy to the brain tumor patients aggressively, we experience that occasionally we are having a chance to see the so-called "chemotherapy death" caused by agranulocytosis and severe infections. In this report we introduced the granulocyte transfusion by the method of filtration leukapheresis in the neurosurgical field, especially its technical aspects, its advantages, and its indications. And we presented a case of pontine glioma who had been successfully treated with the granulocyte transfusion for the agranulocytosis with serious infection. The indication of granulocyte transfusion are as follows: (1) The count of granulocyte is under 500/mm3. (2) The patient has the infection that has no response to the intensive antibiotic therapy for about two days. The advantages of this method of granulocyte transfusion are as follows: (1) Low cost and simple process. (2) The contamination of lymphocyte is little. (3) A large number of granulocyte (1.93 X 10(10)) are obtained from one donor for about two hours. (4) Side effects to donor and patient are very few. We concluded hereafter that this method of granulocyte transfusion should be prepared broadly on the neurosurgical wards in cases of agranulocytosis during the chemotherapy for malignant brain tumors.