Primary graft failure after myeloablative allogeneic hematopoietic cell transplantation for hematologic malignancies

被引：0
作者：
R F Olsson
B R Logan
S Chaudhury
X Zhu
G Akpek
B J Bolwell
C N Bredeson
C C Dvorak
V Gupta
V T Ho
H M Lazarus
D I Marks
O T H Ringdén
M C Pasquini
J R Schriber
K R Cooke
机构：
[1] Karolinska Institutet,Division of Therapeutic Immunology, Department of Laboratory Medicine
[2] Centre for Clinical Research Sörmland,Department of Medicine
[3] Uppsala University,Division of Biostatistics
[4] CIBMTR (Center for International Blood and Marrow Transplant Research),Division of Pediatric Hematology, Department of Pediatrics
[5] Medical College of Wisconsin,Department of Hematology and Oncology
[6] Institute for Health and Society,Department of Pediatrics
[7] Medical College of Wisconsin,undefined
[8] Oncology and Stem Cell Transplant,undefined
[9] Ann & Robert H Lurie Children’s Hospital of Chicago,undefined
[10] Section of Hematology/Oncology,undefined
[11] Banner MD Anderson Cancer Center,undefined
[12] Cleveland Clinic,undefined
[13] The Ottawa Hospital Blood and Marrow Transplant Program and the Ottawa Hospital Research Institute,undefined
[14] University of California San Francisco Medical Center,undefined
[15] Princess Margaret Cancer Centre,undefined
[16] University Health Network,undefined
[17] Center for Hematologic Oncology,undefined
[18] Dana-Farber Cancer Institute,undefined
[19] Seidman Cancer Center,undefined
[20] University Hospitals Case Medical Center,undefined
[21] Pediatric Bone Marrow Transplant,undefined
[22] University Hospitals Bristol NHS Trust,undefined
[23] Cancer Transplant Institute,undefined
[24] Virginia G Piper Cancer Center,undefined
[25] Arizona Oncology,undefined
[26] Pediatric Blood and Marrow Transplantation Program,undefined
[27] The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins,undefined
[28] Centre for Allogeneic Stem Cell Transplantation,undefined
来源：
Leukemia | 2015年 / 29卷
关键词：
D O I：
暂无
中图分类号：
学科分类号：
摘要：
Clinical outcomes after primary graft failure (PGF) remain poor. Here we present a large retrospective analysis (n=23 272) which investigates means to prevent PGF and early detection of patients at high risk. In patients with hematologic malignancies, who underwent their first myeloablative allogeneic hematopoietic cell transplantation, PGF was reported in 1278 (5.5%), and there was a marked difference in PGFs using peripheral blood stem cell compared with bone marrow grafts (2.5 vs 7.3%; P<0.001). A fourfold increase of PGF was observed in myeloproliferative disorders compared with acute leukemia (P<0.001). Other risk factors for PGF included recipient age <30, HLA mismatch, male recipients of female donor grafts, ABO incompatibility, busulfan/cyclophosphamide conditioning and cryopreservation. In bone marrow transplants, total nucleated cell doses ⩽2.4 × 108 per kg were associated with PGF (odds ratio 1.39; P<0.001). The use of tacrolimus-based immunosuppression and granulocyte colony-stimulating factor were associated with decreased PGF risk. These data, allow clinicians to do more informed choices with respect to graft source, donor selection, conditioning and immunosuppressive regimens to reduce the risk of PGF. Moreover, a novel risk score determined on day 21 post transplant may provide the rationale for an early request for additional hematopoietic stem cells.
引用
收藏
页码：1754 / 1762
页数：8
相关论文
共 301 条
  • [1] Jonson FL(1976)Marrow transplantation in treatment of children with aplastic anaemia or acute leukaemia Arch Dis Child 51 403-410
  • [2] Hartmann JR(1976)Aplastic anemia treated by allogeneic bone marrow transplantation: a report on 49 new cases from Seattle Blood 48 817-841
  • [3] Thomas ED(2011)Second allogeneic hematopoietic stem cell transplantation: a treatment for graft failure Clin Transplant 25 E68-E76
  • [4] Chard RL(2010)Second unrelated donor hematopoietic cell transplantation for primary graft failure Biol Blood Marrow Transplant 16 1099-1106
  • [5] Hersman JA(2013)Graft failure in the modern era of allogeneic hematopoietic SCT Bone Marrow Transplant 48 537-543
  • [6] Buckner CD(2008)Graft failure after allogeneic hematopoietic cell transplantation Biol Blood Marrow Transplant 14 165-170
  • [7] Storb R(2009)HLA matching affects clinical outcome of adult patients undergoing haematopoietic SCT from unrelated donors: a study from the Gruppo Italiano Trapianto di Midollo Osseo and Italian Bone Marrow Donor Registry Bone Marrow Transplant 44 571-577
  • [8] Thomas ED(2007)Major ABO blood group mismatch increases the risk for graft failure after unrelated donor hematopoietic stem cell transplantation Biol Blood Marrow Transplant 13 675-682
  • [9] Weiden PL(1971)Peculiar immunobiology of bone marrow allografts. I. Graft rejection by irradiated responder mice J Exp Med 134 83-102
  • [10] Buckner CD(1977)Evidence for a similar or common mechanism for natural killer cell activity and resistance to hemopoietic grafts Eur J Immunol 7 655-663
12345678910