title: Outcome of graft failure after allogeneic stem cell transplant: study of 89 patients.
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 × 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 × 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.
authors.affiliation: Department of Hematology, Institut Català d'Oncologia-Hospital Universitari Germans Trias i Pujol, Josep Carreras Research Institute , Badalona , Spain.
authors.forename: Christelle
authors.initials: C
authors.lastname: Ferrà
authors.forename: Jaime
authors.initials: J
authors.lastname: Sanz
authors.forename: Miguel-Angel
authors.initials: MA
authors.lastname: Díaz-Pérez
authors.forename: Mireia
authors.initials: M
authors.lastname: Morgades
authors.forename: Jorge
authors.initials: J
authors.lastname: Gayoso
authors.forename: José-Rafael
authors.initials: JR
authors.lastname: Cabrera
authors.forename: Teresa
authors.initials: T
authors.lastname: Villaescusa
authors.forename: María-Antonia
authors.initials: MA
authors.lastname: Sampol
authors.forename: Francesc
authors.initials: F
authors.lastname: Fernández-Avilés
authors.forename: Carlos
authors.initials: C
authors.lastname: Solano
authors.forename: Miguel
authors.initials: M
authors.lastname: Ortín
authors.forename: Rafael
authors.initials: R
authors.lastname: Duarte
authors.forename: Marian
authors.initials: M
authors.lastname: Cuesta
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Heras
authors.forename: Javier
authors.initials: J
authors.lastname: de la Serna
authors.forename: José-María
authors.initials: JM
authors.lastname: Moraleda
authors.forename: Cristina
authors.initials: C
authors.lastname: Barrenetxea
authors.forename: Marta
authors.initials: M
authors.lastname: González-Vicent
authors.forename: Guillermo
authors.initials: G
authors.lastname: Sanz
authors.forename: Josep-Maria
authors.initials: JM
authors.lastname: Ribera
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006084:Graft Rejection / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000166:cytology; D033581:Stem Cell Transplantation; D015996:Survival Rate; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
keywords: Graft failure; hematopoietic stem cell transplant; infectious complications; outcome