Here, we describe a case of primary graft failure with severe sepsis in a boy who experienced frequent relapses of osteosarcoma. We have performed this analysis to determine the rate and outcome of GF in the era of modern SCT with better supportive care Interestingly, 4 pts given autologous cells had donor cell engraftment, 1 had spontaneous autologous reconstitution within 3 weeks, 1 died of fatal GVHD and 1 of infection, both after 2 months with persistent donor cells and 1 remained with donor cell until she relapsed 2 years later.

Eighteen pts survived > 1 week after second graft infusion and are evaluable for response. Torres A, Sánchez J, Lakomsky D, Serrano J, Alvarez MA, Martín C, Valls C, Nevado L, Rodriguez A, Casaño J, Martínez F, Gómez P. Methods Mol Biol. Patient characteristics, rescue transplant regimen, engraftment, graft-versus-host-disease (GVHD), and duration of immune suppression post-rescue HCT. Refer to Table 1 for patient and transplant characteristics. Patient 1 was successfully rescued with mobilized peripheral blood stem cells from the same HLA mismatched sibling donor after a minimal toxicity preparative regimen.

Unfortunately, there is a risk of graft rejection as a consequence of donor sensitization and alloimmunization related to transfusion exposures and a hyperproliferative marrow niche.

Carlo-Stella C, Regazzi E, Andrizzi C, Savoldo B, Garau D, Montefusco E, Vignetti M, Mandelli F, Rizzoli V, Meloni G. Tan YM, Fu HR, Luo Y, Shi JM, Ye XJ, Zheng YL, Xiao HW, Hu YX, Huang H. J Int Med Res. Although the patient died due to respiratory failure, transfusion of autologous hematopoietic stem cells is a reasonable rescue option for graft failure even in patients whose background hematopoiesis is reconstituted by a first donor. In all, GF was diagnosed in 25 patients (pts), cumulative incidence (CI) 5.2% (95%ci 3.5–7.6), 21 primary, 4 secondary. 2007;368:237-59. doi: 10.1007/978-1-59745-362-2_17. Fludarabine 30mg/m2 on days -4 through -2; Fludarabine 30 mg/m2 on days -6 through -2; Duration of Post-Rescue Transplant Immune Suppression. 2011;39(3):950-9. doi: 10.1177/147323001103900330. Engraftment occurred within a median of 10 days (range, 5–15). The patient had undergone haploidentical bone marrow transplant after engraftment of unrelated cord blood transplant performed 10 months earlier.

Donor graft failure (GF) is a life-threatening complication of allogeneic stem cell transplantation (SCT). Considering his severe condition, we transfused autologous peripheral stem cells along with a single dose of etoposide (50 mg/m2). Blood 2007; 110 (11): 2998. doi: https://doi.org/10.1182/blood.V110.11.2998.2998.

Graft failure is a condition in which normal bone marrow function does not return following a stem cell transplant. HHS Pts with a predominant host population or rapidly decreasing donor chimerism on successive tests, suggesting immune rejection, were given autologous back-up cells or a second SCT from a different donor. Graft failure is a serious complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) defined as either lack of initial engraftment of donor cells (primary graft failure) or loss of donor cells after initial engraftment Asterisk with author names denotes non-ASH members. Graft failure (GF) following an allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a complex syndrome characterized by pancytopenia and hypocellular or acellular bone marrow. Blood 2015; 126 (23): 5460. doi: https://doi.org/10.1182/blood.V126.23.5460.5460.

Nahal Rose Lalefar, Mark C. Walters; Graft Failure after Hematopoietic Cell Transplantation for Hemoglobin Disorders: Successful Application of a Rescue Regimen.

Graft failure is a serious complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) defined as either lack of initial engraftment of donor cells (primary graft failure) or loss of donor cells after initial engraftment (secondary graft failure). The nature and severity of the side effects from high-dose chemotherapy and autologous stem cell transplantation are directly related to the type of high-dose chemotherapy treatment regimen used and are further influenced by the condition and age of the patient. Search for other works by this author on: Copyright ©2020 by American Society of Hematology, Clinical Care - Transplantation Regimen Toxicities and Engraftment, https://doi.org/10.1182/blood.V110.11.2998.2998.

We reviewed 3 patients with hemoglobin disorders who were successfully rescued by alternative transplantation regimens following primary or secondary graft failures. Following transplant, the graft may fail to grow in the patients’ body, which will result in bone marrow failure and the absence of new blood cell production.