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

被引:33
作者
Ferra, Christelle [1 ]
Sanz, Jaime [2 ]
Diaz-Perez, Miguel-Angel [3 ]
Morgades, Mireia [1 ]
Gayoso, Jorge [4 ]
Cabrera, Jose-Rafael [5 ]
Villaescusa, Teresa [6 ]
Sampol, Maria-Antonia [7 ]
Fernandez-Aviles, Francesc [8 ]
Solano, Carlos [9 ]
Ortin, Miguel [10 ]
Duarte, Rafael [11 ]
Cuesta, Marian [12 ]
Heras, Inmaculada [13 ]
de la Serna, Javier [14 ]
Moraleda, Jose-Maria [15 ]
Barrenetxea, Cristina [16 ]
Gonzalez-Vicent, Marta [3 ]
Sanz, Guillermo [2 ]
Ribera, Josep-Maria [1 ]
机构
[1] Hosp Badalona Germans Trias & Pujol, Dept Hematol, Inst Catala Oncol, Josep Carreras Res Inst, Badalona, Spain
[2] Hosp La Fe, Dept Hematol, E-46009 Valencia, Spain
[3] Hosp Nino Jesus, Dept Hematol, Madrid, Spain
[4] Hosp Gen Gregorio Maranon, Dept Hematol, Madrid, Spain
[5] Hosp Puerta Hierro, Dept Hematol, Madrid, Spain
[6] Hosp Univ Salamanca, Dept Hematol, Salamanca, Spain
[7] Hosp Son Espases, Dept Hematol, Palma de Mallorca, Spain
[8] Hosp Clin Barcelona, Dept Hematol, Barcelona, Spain
[9] Hosp Clin Univ, Dept Hematol, Valencia, Spain
[10] Hosp Santa Creu & Sant Pau, Dept Hematol, Barcelona, Spain
[11] Hosp Duran & Reynals, Dept Hematol, Inst Catala Oncol, Lhospitalet De Llobregat, Spain
[12] Hosp Carlos Haya, Dept Hematol, Malaga, Spain
[13] Hosp Morales Meseguer, Dept Hematol, Murcia, Spain
[14] Hosp 12 Octubre, Dept Hematol, Madrid, Spain
[15] Hosp Virgen Arreixaca, Dept Hematol, Murcia, Spain
[16] Hosp Valle De Hebron, Dept Hematol, Barcelona, Spain
关键词
Graft failure; hematopoietic stem cell transplant; outcome; infectious complications; CORD BLOOD TRANSPLANTATION; PERIPHERAL-BLOOD; BONE-MARROW; ENGRAFTMENT; FLUDARABINE; REJECTION; RELAPSE; GVHD;
D O I
10.3109/10428194.2014.930849
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
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.
引用
收藏
页码:656 / 662
页数:7
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