Second transplantation for graft failure after allogeneic hematopoietic stem cell transplantation--a retrospective survey by Kanto Study Group for Cell Therapy

Maki Hagihara, Heiwa Kanamori, Miwa Sakai, Takehiko Mori, Chiaki Nakaseko, Nobuyuki Aotsuka, Taeko Uehara, Tohru Sakura, Fumio Yoshiba, Nobutaka Kawai, Masatsugu Tanaka, Shin Fujisawa, Chikako Ohwada, Hisashi Wakita, Akira Yokota, Toshihide Kawamura, Atsuo Maruta, Hisashi Sakamaki, Shinichiro Okamoto, Study Group for Cell Therapy (KSGCT) Kanto Study Group for Cell Therapy (KSGCT)

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Abstract

We retrospectively surveyed patients who received a second transplantation for graft failure (GF) after allogeneic hematopoietic stem cell transplantation (SCT) in hospitals participating in the Kanto Study Group for Cell Therapy. A second SCT was performed in 21 of 45 patients with primary GF and in 13 of 15 with secondary GF. The median time between the first and second SCT was 49 days (range, 18-1204 days). The diagnosis included 28 patients with hematologic malignancies and 6 with aplastic anemia. Non-myeloablative or reduced-intensity conditioning was performed in 30 patients. Cord blood was frequently used as the source of stem cells followed by related donor peripheral blood, and unrelated bone marrow. Engraftment was achieved in 23 patients (68%). Conditioning regimen including total body or total lymphoid irradiation, was significantly associated with a higher engraftment rate. Overall survival at 5 years in all patients who underwent second SCT was 34%. Prognostic factors for better survival after second SCT were a time to second SCT longer than 90 days, the performance status at second SCT with 0 or 1, and the administration of tacrolimus for GVHD prophylaxis. The major cause of death after second SCT was infection. Although the outcome of a second SCT for graft failure remains poor, these findings suggest that the selection of patients as well as transplant methods, such as conditioning and GVHD prophylaxis, may contribute to survival.

Original languageEnglish
Pages (from-to)390-397
Number of pages8
Journal[Rinshō ketsueki] The Japanese journal of clinical hematology
Volume51
Issue number6
Publication statusPublished - 2010 Jun

ASJC Scopus subject areas

  • Medicine(all)

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    Hagihara, M., Kanamori, H., Sakai, M., Mori, T., Nakaseko, C., Aotsuka, N., Uehara, T., Sakura, T., Yoshiba, F., Kawai, N., Tanaka, M., Fujisawa, S., Ohwada, C., Wakita, H., Yokota, A., Kawamura, T., Maruta, A., Sakamaki, H., Okamoto, S., & Kanto Study Group for Cell Therapy (KSGCT), S. G. F. C. T. KSGCT. (2010). Second transplantation for graft failure after allogeneic hematopoietic stem cell transplantation--a retrospective survey by Kanto Study Group for Cell Therapy. [Rinshō ketsueki] The Japanese journal of clinical hematology, 51(6), 390-397.