PURPOSE: To determine the incidence, etiology and outcome of graft failure in pediatric allogeneic bone marrow transplant (BMT) recipients. PATIENTS AND METHODS: Patients with primary or secondary graft failure were identified by database review. A retrospective chart review was performed. Etiologic factors were identified and assessed for statistical significance. RESULTS: 309 children underwent allogeneic BMT during the time interval studied. Four cases of primary graft failure and 7 cases of secondary graft failure occurred. Nonmalignant diagnosis, lower total nucleated cell (TNC) dose, and conditioning without total body irradiation were associated with a higher incidence of graft failure. Donor source, donor/recipient CMV status, CD34+ cell dose, and alloimmunization were not associated with graft failure. CONCLUSIONS: Graft failure is a relatively uncommon occurrence in pediatric patients. Autologous reinfusion may allow time to prepare the patient for a second transplant and decrease complications associated with aplasia. More immunosuppressive conditioning regimens may decrease the incidence of graft failure, particularly in patients with non-malignant diseases or those with lower stem cell doses. More frequent monitoring of chimerism by VNTR analysis may detect late graft failure earlier and allow for more rapid intervention.
PURPOSE: To determine the incidence, etiology and outcome of graft failure in pediatric allogeneic bone marrow transplant (BMT) recipients. PATIENTS AND METHODS: Patients with primary or secondary graft failure were identified by database review. A retrospective chart review was performed. Etiologic factors were identified and assessed for statistical significance. RESULTS: 309 children underwent allogeneic BMT during the time interval studied. Four cases of primary graft failure and 7 cases of secondary graft failure occurred. Nonmalignant diagnosis, lower total nucleated cell (TNC) dose, and conditioning without total body irradiation were associated with a higher incidence of graft failure. Donor source, donor/recipient CMV status, CD34+ cell dose, and alloimmunization were not associated with graft failure. CONCLUSIONS:Graft failure is a relatively uncommon occurrence in pediatric patients. Autologous reinfusion may allow time to prepare the patient for a second transplant and decrease complications associated with aplasia. More immunosuppressive conditioning regimens may decrease the incidence of graft failure, particularly in patients with non-malignant diseases or those with lower stem cell doses. More frequent monitoring of chimerism by VNTR analysis may detect late graft failure earlier and allow for more rapid intervention.
Authors: H J Im; K N Koh; J K Suh; S W Lee; E S Choi; S Jang; S W Kwon; C-J Park; J J Seo Journal: Bone Marrow Transplant Date: 2014-10-13 Impact factor: 5.483
Authors: L Gao; Y Li; Y Zhang; X Chen; L Gao; C Zhang; Y Liu; P Kong; Q Wang; Y Su; C Wang; S Wang; B Li; A Sun; X Du; D Zeng; J Li; H Liu; X Zhang Journal: Bone Marrow Transplant Date: 2014-01-27 Impact factor: 5.483
Authors: Gabriela Rondón; Rima M Saliba; Issa Khouri; Sergio Giralt; Kawah Chan; Elias Jabbour; John McMannis; Richard Champlin; Elizabeth Shpall Journal: Biol Blood Marrow Transplant Date: 2008-08 Impact factor: 5.742
Authors: Anthony Sabulski; Kasiani C Myers; Jack J Bleesing; Alexandra Duell; Adam Lane; Ashley Teusink-Cross; Stella M Davies; Sonata Jodele Journal: Blood Adv Date: 2021-11-23