title: [Second transplantation for 22 patients with graft failure after first allogeneic stem cell transplantation].
abstract: OBJECTIVE
  To improve the understanding of treatment for graft failure by analyzing the efficacy of second transplantation for graft failure after first allogeneic stem cell transplantation (allo-HSCT).
  
  
  METHODS
  Twenty-two patients encountered graft failure after first allo-HSCT from Peking University Institute of Hematology were retrospectively reviewed. The incidence of re-engratment, graft versus host disease (GVHD) and overall survival (OS) was analyzed. Also the factors associated with re-engraftment and OS were analyzed in multivariate model.
  
  
  RESULTS
  Twenty-two patients encountered graft failure, including 12 primary graft failure and 10 secondary graft failure. 13(59.1%) patients acquired engraftment. And 13 patients acquired neutropil engraftment with median time of 15 (7-26) days, while 9 patients acquired platelet engraftment with median time of 12 (7-14) days. None of the factors included in mulivariate analysis showed impact on engraftment. The treatment related mortality at 100 day and 3 years after second transplantation was 40.9% and 72.7%, respectively. The main cause of death was infection (13/17). The 3-year OS was 22.7%, and the main cause of death was infection (13/17). The factors associated with OS included primary graft failure [P=0.001, HR 40.207 (4.828-334.868)] and receiving second transplantation in 60 days after first transplantation [P=0.003, HR 12.340 (2.290-66.498)].
  
  
  CONCLUSIONS
  Second transplantation may be an effective salvage choice for graft failure. However, the efficacy was far from satisfactory.
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for the Treatment of Hematological Diseases, Beijing 100044, China.
authors.forename: Yuqian
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for the Treatment of Hematological Diseases, Beijing 100044, China.
authors.forename: Lanping
authors.initials: L
authors.lastname: Xu
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for the Treatment of Hematological Diseases, Beijing 100044, China.
authors.forename: Daihong
authors.initials: D
authors.lastname: Liu
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for the Treatment of Hematological Diseases, Beijing 100044, China.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for the Treatment of Hematological Diseases, Beijing 100044, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for the Treatment of Hematological Diseases, Beijing 100044, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Han
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for the Treatment of Hematological Diseases, Beijing 100044, China.
authors.forename: Yuhong
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for the Treatment of Hematological Diseases, Beijing 100044, China.
authors.forename: Huan
authors.initials: H
authors.lastname: Chen
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for the Treatment of Hematological Diseases, Beijing 100044, China.
authors.forename: Jingzhi
authors.initials: J
authors.lastname: Wang
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for the Treatment of Hematological Diseases, Beijing 100044, China.
authors.forename: Kaiyan
authors.initials: K
authors.lastname: Liu
authors.affiliation: Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation for the Treatment of Hematological Diseases, Beijing 100044, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection; D006402:Hematologic Diseases / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult