We have evaluated clinical outcomes in 49 patients who received unmanipulated allogeneic hematopoietic stem cell transplantation (allo-HSCT) as a salvage treatment for primary (PGF) and secondary graft failure (SGF). The median age of patients was 31 years. Indications for the first allo-HSCT were malignant (n=43, 88%) and nonmalignant diseases (n=6, 12%). Thirteen patients with malignant diseases (27%) were in the active phase of disease. Patients with PGF received a second graft, at a median interval of 43 days (34-82) after allo-HSCT. The second allo-HSCT (HSCT2) were performed from haploidentical (n=42, 86%), HLA-matched related (n=2, 4%) and unrelated (n=5, 10%) donors. Donor-specific antibodies (DSA) before the 1 st allo-HSCT (HSCT1) were examined in 21 cases, and detected in 7 patients. Donor change in 2 nd HSCT was performed in 23 cases. Following HSCT2, the neutrophil counts exceeding 0.5×10 9 /L were achieved in 21(43%) patients with a cumulative incidence (CI) of 33% (95% CI, 19-48) and median engraftment time of 29 (1-41) days; blood platelet counts over 50×10 9 /L were achieved in 11(22%) patients. The 3 rd allo-HSCT was required in 14 patients. A total of 34 patients died, the cause of death in 31 cases was infection, in three cases -relapse of the underlying disease. The one-year relapse-free survival rate after HSCT2 was 65% (95% CI 51-79), the one-year event-free survival rate) was 20% (95%CI, 11-37) with relapce, acute graft-versus-host disease (aGvHD) grade 3-4 considered as event.One-year overall survival (OS) was 33% (95% CI, 22-50), 5 year OS was 28% (95% CI, 18-45). Source of the graft was the only factor which showed an association with OS: usage of peripheral blood stem cells (50%; 95%, CI 31-66) versus bone marrow (26%; 95% CI 2-65, p=0.049).