Outcome of graft failure after allogeneic stem cell transplant: study of 89 patients

Ferrà, Christelle; Sanz, Jaime; Diaz-Perez, M Angel; Morgades, Mireia; Gayoso, Jorge; Cabrera, J. Rafael; Villaescusa, Teresa; Sampol, María-Antonia; Fernández‐Avilés, Francesc; Solano, Carlos; Ortín, Miguel; Duarte, Rafael F.; Cuesta, Marian; Heras, Inmaculada; Serna, Javier de la; Moraleda, J.; Barrenetxea, Cristina; González‐Vicent, Marta; Sanz, Guillermo; Ribera, Josep‐Marǐa

doi:10.3109/10428194.2014.930849

Cited by 39 publications

(32 citation statements)

References 27 publications

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“…Second allo-SCT or infusions of unmanipulated peripheral blood stem cells are other options but are associated with a high risk of GvHD and non relapse mortality 6 . Larocca et al 7 reported the use of CD34 + -selected stem cell infusions from the original donor without conditioning for correction of poor GF based upon the premise that the risk of GvHD would be low.…”

Section: Introductionmentioning

confidence: 99%

Predictors of recovery following allogeneic CD34+-selected cell infusion without conditioning to correct poor graft function

Cuadrado¹,

Szydlo²,

Watts³

et al. 2019

haematol

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Poor graft function is a serious complication following allogeneic hematopoietic stem cell transplantation. Infusion of CD34 +-selected stem cells without pre-conditioning has been used to correct poor graft function, but predictors of recovery are unclear. We report the outcome of 62 consecutive patients who had primary or secondary poor graft function who underwent a CD34 +selected stem cell infusion from the same donor without further conditioning. Forty-seven of 62 patients showed hematological improvement and became permanently transfusion and growth factor-independent. In multivariate analysis, parameters significantly associated with recovery were shared CMV seronegative status for recipient/donor, the absence of active infection and matched recipient/donor sex. Recovery was similar in patients with mixed and full donor chimerism. Five-year overall survival was 74.4% (95% CI 59-89) in patients demonstrating complete recovery, 16.7% (95% CI 3-46) in patients with partial recovery and 22.2% (CI 95% 5-47) in patients with no response. In patients with count recovery, those with poor graft function in 1-2 lineages had superior 5-year overall survival (93.8%, 95% CI 82-99) than those with tri-lineage failure (53%, 95% CI 34-88). New strategies including cytokine or agonist support, or second transplant need to be investigated in patients who do not recover.

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Section: Introductionmentioning

confidence: 99%

Predictors of recovery following allogeneic CD34+-selected cell infusion without conditioning to correct poor graft function

Cuadrado¹,

Szydlo²,

Watts³

et al. 2019

haematol

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“…Cord blood, unrelated donors, or haploidentical transplantation are alternatives. However, the literature is scarce on the subject, and the long-term overall survival (OS) of retransplanted patients is estimated to be about 30% [4].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Salvage Haploidentical Transplant with Post-Transplant Cyclophosphamide for Rescuing Graft Failure Patients: a Report on Behalf of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy

Prata

Resche‐Rigon

Blaise

et al. 2019

Biology of Blood and Marrow Transplantation

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Prognosis of patients with graft failure is dismal, and retransplantation is the sole option for long-term survival. To address the interest of haploidentical transplantation as a salvage option in this context, we analyzed data from 24 patients with graft failure or loss retransplanted with a haploidentical donor who received post-transplant cyclophosphamide (PTCy) as graft-versus-host disease prophylaxis (GVHD). Fludarabine-based reduced-intensity conditioning was used in 23 patients and the Baltimore regimen in 14 patients. The median delay between previous and salvage transplantation for graft failure was 63 days (range, 39 to 98). In addition to PTCy, all patients received cyclosporine, and 22 patients also received mycophenolate mofetil for GVHD prophylaxis. With a median followup of 353 days (range, 16 to 2010), 1-year overall survival (OS) was 56% (95% confidence interval, 38% to 81%). Transplant complications accounted for 80% of deaths. The cumulative incidence of neutrophil engraftment at day +30 was 79%. Cumulative incidence of grades II to IV acute GVHD at day 100 was 14%, and 1-year cumulative incidence of chronic GVHD was 31%. One-year cumulative incidence of relapse was 13%. Stem cell source did not impact on engraftment, GVHD, relapse, or OS. Salvage haploidentical transplant with PTCy for rescuing graft failure patients leads to an acceptable 1-year OS and might be a valid option in this poor situation.

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“…[1][2][3] As a salvage therapy, second allogeneic transplantation (alloSCT2) results in high rates of non-relapse mortality (NRM). [1][2][3] As a salvage therapy, second allogeneic transplantation (alloSCT2) results in high rates of non-relapse mortality (NRM).…”

mentioning

confidence: 99%

“…Graft failure is a rare but potentially life-threatening complication of allogeneic stem cell transplantation (alloSCT) occurring in approximately 5% of transplants. [1][2][3] As a salvage therapy, second allogeneic transplantation (alloSCT2) results in high rates of non-relapse mortality (NRM). [3][4][5][6][7][8] Haploidentical transplantation utilising posttransplant cyclophosphamide (PTCy) appears to result in low NRM in the upfront setting and may similarly reduce NRM in the salvage alloSCT context.…”

mentioning

confidence: 99%

“…[1][2][3] As a salvage therapy, second allogeneic transplantation (alloSCT2) results in high rates of non-relapse mortality (NRM). [3][4][5][6][7][8] Haploidentical transplantation utilising posttransplant cyclophosphamide (PTCy) appears to result in low NRM in the upfront setting and may similarly reduce NRM in the salvage alloSCT context. 9,10 We identified all patients who had received alloSCT2 between the years 2011 and 2016 from a search of the Westmead Hospital Blood and Marrow Transplant Unit database.…”

mentioning

confidence: 99%

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Rescue haploidentical peripheral blood stem cell transplantation for engraftment failure: a single‐centre case series

Kliman

Bilmon

Kwan

et al. 2018

Internal Medicine Journal

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Graft failure affects approximately 5% of allogeneic stem cell transplants, with a poor prognosis. Salvage second allogeneic stem cell transplantation (alloSCT2) is limited by high rates of transplant-related mortality from infection and graft-versus-host disease. We report on five adult patients receiving rescue alloSCT2 using haploidentical peripheral blood stem cells. All patients achieved neutrophil engraftment, two subsequently died from sepsis and disease relapse, respectively. Three patients remain alive up to 2 years post-transplant. We suggest consideration of haploidentical alloSCT2 for patients with graft failure.

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Outcome of graft failure after allogeneic stem cell transplant: study of 89 patients

Cited by 39 publications

References 27 publications

Predictors of recovery following allogeneic CD34+-selected cell infusion without conditioning to correct poor graft function

Predictors of recovery following allogeneic CD34+-selected cell infusion without conditioning to correct poor graft function

Outcomes of Salvage Haploidentical Transplant with Post-Transplant Cyclophosphamide for Rescuing Graft Failure Patients: a Report on Behalf of the Francophone Society of Bone Marrow Transplantation and Cellular Therapy

Rescue haploidentical peripheral blood stem cell transplantation for engraftment failure: a single‐centre case series

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