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

Autores de IIS La Fe

• Jaime Sanz Caballer

  Autor

• Guillermo Sanz Santillana

  Autor

Participantes ajenos a IIS La Fe

• Ferrà C
• Díaz-Pérez MA
• Morgades M
• Gayoso J
• Cabrera JR
• Villaescusa T
• Sampol MA
• Fernández-Avilés F
• Solano C
• Ortín M
• Duarte R
• Cuesta M
• Heras I
• de la Serna J
• Moraleda JM
• Barrenetxea C
• González-Vicent M
• Ribera JM
• Grupo Español de Trasplante Hematopoyético (Geth) Spanish Society of Hematology

Grupos

• Hematología y Hemoterapia

  

  Investigador Principal

  Javier De La Rubia Comos

Abstract

Strategies for reversing graft failure (GF) after allogeneic stem cell transplant (SCT) depend on the options available in each situation. GF was reported in 16 Spanish institutions from January 2006 to July 2011. Primary GF was defined as an absolute neutrophil count (ANC) > 0.5 x 10(9)/L not reached by day + 28 after SCT from peripheral blood (PB) or bone marrow (BM) progenitors and by day + 42 after SCT from unrelated cord blood (UCB) progenitors. Secondary GF was defined as a recurrent ANC < 0.5 x 10(9)/L. Eighty-nine patients with GF were reported, and 80 patients received a second SCT. The 5-year survival probability was 31% (95% confidence interval [CI]: 18-44%), and the incidences of non-relapse mortality and relapse estimated by competing risks were 47% (95% CI: 36-58%) and 21% (95% CI: 4-28%). The strategy adopted to treat GF was heterogeneous, and no approach could be unequivocally recommended for this situation. The prognosis of patients with GF was poor even after successful recovery from GF.

Keywords

• Graft failure; hematopoietic stem cell transplant; outcome; infectious complications