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Graft failure after allogeneic hematopoietic stem cell transplantation in pediatric patients with acute leukemia: autologous reconstitution or second transplant?
- Source :
-
Stem cell research & therapy [Stem Cell Res Ther] 2024 Apr 22; Vol. 15 (1), pp. 111. Date of Electronic Publication: 2024 Apr 22. - Publication Year :
- 2024
-
Abstract
- Background: Graft failure (GF) is a rare but serious complication after allogeneic hematopoietic stem cell transplantation (HSCT). Prevention of graft failure remains the most advisable approach as there is no clear recommendation for the best strategies for reversing this complication. Administration of growth factor, additional hematopoietic progenitor boost, or a salvage HSCT are current modalities recommended for the treatment of GF. Autologous recovery without evidence of disease relapse occurs rarely in patients with GF, and in the absence of autologous recovery, further salvage transplantation following a second conditioning regimen is a potential treatment option that offers the best chances of long-term disease-free survival. The preconditioning regimens of second HSCT have a significant impact on engraftment and outcome, however, currently there is no consensus on optimal conditioning regimen for second HSCT in patients who have developed GF. Furthermore, a second transplant from a different donor or the same donor is still a matter of debate.<br />Observations: We present our experience in managing pediatric patients with acute leukemia who encountered graft failure following stem cell transplantation.<br />Conclusions and Relevance: Although a second transplantation is almost the only salvage method, we illustrate that some pediatric patients with acute leukemia who experience graft failure after an allogeneic stem cell transplant using Myeloablative conditioning (MAC) regimen may achieve long-term disease-free survival through autologous hematopoiesis recovery.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Child
Female
Male
Child, Preschool
Transplantation, Homologous methods
Adolescent
Graft Rejection
Acute Disease
Transplantation, Autologous
Infant
Leukemia, Myeloid, Acute therapy
Hematopoietic Stem Cell Transplantation methods
Hematopoietic Stem Cell Transplantation adverse effects
Transplantation Conditioning methods
Subjects
Details
- Language :
- English
- ISSN :
- 1757-6512
- Volume :
- 15
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Stem cell research & therapy
- Publication Type :
- Academic Journal
- Accession number :
- 38644499
- Full Text :
- https://doi.org/10.1186/s13287-024-03726-z