ArticleBone marrow transplantation2023
Long-term outcome of second allogeneic hematopoietic stem cell transplantation (HSCT2) for primary graft failure in patients with acute leukemia in remission: A study on behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.
Article in Bone marrow transplantation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 13 citations in OpenAlex.
- When the first graft fails: a strategic approach to donor selection for second transplant.Haematologica · 2026Article
- Changing donors improves outcomes of second transplantation in patients who experienced graft failure after first allogeneic stem cell transplantation.Haematologica · 2026Article
- Outcomes of primary graft failure in acute myeloid leukemia patients following unrelated transplantation with post-transplant cyclophosphamide: a study from the ALWP/EBMT.Bone marrow transplantation · 2026Article
- Outcomes Following Second Allogeneic Stem Cell Transplant for Graft Failure or Poor Graft Function: A Single Centre Experience.Stem cell reviews and reports · 2025Article
- Successful third haploidentical hematopoietic stem cell transplantation after two graft failures in a pediatric patient with severe aplastic anemia: a case report with five-year follow-up.Frontiers in immunology · 2025Article
- Graft failure after allogeneic hematopoietic stem cell transplantation in pediatric patients with acute leukemia: autologous reconstitution or second transplant?Stem cell research & therapy · 2024Review
- Ovarian tissue cryopreservation after graft failure of allogeneic hematopoietic stem cell transplantation: first report and literature review.Frontiers in endocrinology · 2024Review
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Authors and funding
17 authors at 14 institutions in 9 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Second transplantation (HSCT2) is a potential treatment for primary graft failure (pGF). We assessed the outcome of HSCT2, performed between 2000 and 2021, for pGF in 243 patients with acute leukemia. Median age was 44.8 years. Conditioning at first HSCT (HSCT1) was myeloablative (MAC) in 58.4%. Median time from HSCT1 to HSCT2 was 48 days. Donors for HSCT2 were the same as for HSCT1 in 49%. Engraftment post HSCT2 was achieved by 73.7% of patients. The incidence of acute (a) graft versus host disease (GVHD) grades II-IV and III-IV was 23.2 and 8.1%. 5-year total and extensive chronic (c) GVHD was 22.3 and 10.1%. 5-year nonrelapse mortality (NRM), relapse incidence (RI), leukemia-free survival (LFS), overall survival (OS) and GVHD free, relapse-free survival (GRFS) was 51.6, 18.8, 29.6, 30.7 and 22.4%, respectively. Infections were the main cause of death. In multivariable analysis, being transplanted at second vs. first remission, lower Karnofsky performance status (KPS; <90) and receiving MAC at HSCT1 were adverse prognostic factors for NRM, LFS, OS, and GRFS, as was increased age for NRM, LFS, OS. We conclude that HSCT2 can rescue about a third of the patients who experienced pGF, but NRM is as high as 50%.
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