title: The harvest and use of autologous back-up grafts for graft failure or severe GVHD after allogeneic hematopoietic stem cell transplantation: a survey of the European Group for Blood and Marrow Transplantation.
abstract: Autologous hematopoietic stem cells (HSCs) harvested as back-up prior to allogeneic hematopoietic SCT (HSCT) may potentially be useful in the treatment of graft failure or in cases with severe GVHD. Here, we studied the general policies and indications for autologous back-up harvest among the European Group for Blood and Marrow Transplantation centers in the year 2003. The outcome of patients receiving autologous back-up transfusion between 1998 and 2002 was evaluated retrospectively. The responses from 94 centers showed that 48 centers had a general policy with variable indications for autologous back-up harvest. Thirty-five patients with graft failure (25), GVHD (8) or relapse (2) retransplanted with autologous back-ups were reported. Autologous back-up transfusion was performed at a median of 35 days (patients with graft failure) or 90 days (patients with GVHD) after allogeneic HSCT. Within 100 days after autologous HSCT, 21 patients died from treatment-related complications (19) or relapse (2). Estimated overall survival at 1 year was 16% (95% CI 0-32%) for patients treated for graft failure and 13% (95% CI 0-37%) for GVHD patients. In conclusion, our data demonstrate that the indication for autologous back-up harvests is limited and that general storage and use cannot be recommended unless in selected prospective studies.
authors: Department of Medicine, Hematology and Oncology, University of Muenster, Muenster, Germany. stelljes@uni-muenster.de
authors: M
authors: M
authors: Stelljes
authors: A
authors: A
authors: van Biezen
authors: S
authors: S
authors: Slavin
authors: E
authors: E
authors: Olavarria
authors: R E
authors: RE
authors: Clark
authors: A
authors: A
authors: Nagler
authors: V
authors: V
authors: Koza
authors: J
authors: J
authors: Kienast
authors: D
authors: D
authors: Niederwieser
authors: T
authors: T
authors: de Witte
authors: T
authors: T
authors: Ruutu
mesh_terms: D000293:Adolescent; D000328:Adult; D001803:Blood Transfusion; D002648:Child; D002675:Child, Preschool; D005060:Europe; D005260:Female; D006086:Graft vs Host Disease / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013997:Time Factors; D014184:Transplantation, Homologous / Q000379:methods*; D016896:Treatment Outcome