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Second unrelated donor hematopoietic cell transplantation for primary graft failure. Biol Blood Marrow Transplant 2010 Aug;16(8):1099-106

Date

02/23/2010

Pubmed ID

20172038

Pubmed Central ID

PMC2897953

DOI

10.1016/j.bbmt.2010.02.013

Scopus ID

2-s2.0-77954316434   48 Citations

Abstract

Failure to engraft donor cells is a devastating complication after allogeneic hematopoietic cell transplantation (HCT). We describe the results of 122 patients reported to the National Marrow Donor Program between 1990 and 2005, who received a second unrelated donor HCT after failing to achieve an absolute neutrophil count of >or=500/microL without recurrent disease. Patients were transplanted for leukemia (n = 83), myelodysplastic disorders (n = 16), severe aplastic anemia (n = 20), and other diseases (n = 3). The median age was 29 years. Twenty-four patients received second grafts from a different unrelated donor. Among 98 patients who received a second graft from the same donor, 28 received products that were previously collected and cryopreserved for the first transplantation. One-year overall survival (OS) after second transplant was 11%, with 10 patients alive at last follow-up. We observed no differences between patients who received grafts from the same or different donors, or in those who received fresh or cryopreserved product. The outcomes after a second allogeneic HCT for primary graft failure are dismal. Identifying risk factors for primary graft failure can decrease the incidence of this complication. Further studies are needed to test whether early recognition and hastened procurement of alternative grafts can improve transplant outcomes for primary graft failure.

Author List

Schriber J, Agovi MA, Ho V, Ballen KK, Bacigalupo A, Lazarus HM, Bredeson CN, Gupta V, Maziarz RT, Hale GA, Litzow MR, Logan B, Bornhauser M, Giller RH, Isola L, Marks DI, Rizzo JD, Pasquini MC

Authors

Marcelo C. Pasquini MD, MS Professor in the Medicine department at Medical College of Wisconsin
J. Douglas D. Rizzo MD, MS Director, Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Child
Child, Preschool
Female
Graft Rejection
Hematopoietic Stem Cell Transplantation
Humans
Male
Middle Aged
Survival Rate
Tissue Donors
Treatment Outcome
Young Adult
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a