Salvage allogeneic hematopoietic SCT for primary graft failure in children

M. Kato, K. Matsumoto, R. Suzuki, H. Yabe, M. Inoue, H. Kigasawa, J. Inagaki, K. Koh, Y. Hashii, H. Tauchi, A. Suminoe, A. Kikuta, H. Sakamaki, K. Kawa, K. Kato, T. Fukuda

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    Abstract

    Primary graft failure (pGF) is associated with considerable morbidity and mortality. Salvage hematopoietic SCT (HSCT) can rescue pGF patients; however, the optimal preconditioning regimen and stem cell source are yet to be determined, particularly in children. In this study, we retrospectively analyzed 102 pediatric patients who received salvage allogeneic HSCT for pGF. Salvage HSCT from matched or one-Ag-mismatched related donors (rMM01) provided superior OS compared with that from two- or three-Ags-mismatched related donors (rMM23) or cord blood transplantation (CBT). CBT showed a trend toward a slightly lower engraftment rate and late engraftment achievement compared with rMM23; however, the OS rate was similar between the two groups (47.6±7.7% for rMM23 and 45.7±8.6% for CBT, at 1 year after salvage HSCT). Multivariate analysis showed that preconditioning regimens with fludarabine or irradiation were associated with a higher engraftment rate and those with alkylating agents were associated with better OS. In conclusion, our results showed that rMM01 was the most suitable donor for salvage HSCT for pediatric pGF, and that CBT was an equally important option compared with rMM23 for patients without rMM01.

    Original languageEnglish
    Pages (from-to)1173-1178
    Number of pages6
    JournalBone Marrow Transplantation
    Volume48
    Issue number9
    DOIs
    Publication statusPublished - Sep 1 2013

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    All Science Journal Classification (ASJC) codes

    • Hematology
    • Transplantation

    Cite this

    Kato, M., Matsumoto, K., Suzuki, R., Yabe, H., Inoue, M., Kigasawa, H., ... Fukuda, T. (2013). Salvage allogeneic hematopoietic SCT for primary graft failure in children. Bone Marrow Transplantation, 48(9), 1173-1178. https://doi.org/10.1038/bmt.2013.36