Successful Use of Granulocyte Transfusion Therapy as a Bridge to Hematopoietic Stem Cell Transplant in a Child with Aplastic Anemia and Refractory Perirectal Abscess

This brief report describes the use of adjuvant granulocyte transfusion therapy to successfully treat antibiotic refractory proctitis with perirectal abscess in a child with very severe aplastic anemia (vsAA). She was not expected to have imminent neutrophil recovery, which by current practice guidelines is a prerequisite for the consideration of granulocyte transfusion; however, the risk of bowel perforation potentially hastened by conditioning and/or engraftment precluded curative hematopoietic stem cell transplantation, presenting a significant treatment conundrum. This case highlights an expanded clinical indication for granulocyte therapy in a uniquely vulnerable patient population.