Abstract
Background: Graft failure is a complication of hematopoietic stem cell transplantation (HSCT) which is mostly effected achievement of HSCT. The incidence of graft failure is variable 4% to 20 % according to donor types. Determination of factors that affecting on graft failure will help to physicians for improving achievement of HSCT and prevention from graft failure. In this retrospective review, we analyzed some parameters that can have an effect on primary and secondary graft failure and we also reviewed treatment options that had been used in primary and secondary graft failure. Aims: Determination of factors that have been affected on graft failure and treatment options in graft failure. Methods: We retrospectively examined 345 recipient/donor's clinicopathologic characteristics which may have an effect on graft failure after allogenic HSCT. Results: Fifteen (4,3%) of 345 recipient had graft failure. Eight (53,3%) of 15 recipient had primary graft failure, 7 (46.7%) of 15 recipient had secondary graft failure. We found significant relationship between graft failure with conditioning, recipient/ donor (R/D) HLA status, R/D ABO status, R/D Cytomegaliovirus (CMV) status at pre transplant evaluation. (p<0,05). Treatment options and response in graft failure are as following : 7 of 15 recipient received DLI treatment;. 4 of 7 recipient responded to DLI treatment. Three of 15 recipient received CD 34+ cells from the same donor; 2 of 3 recipient responded to CD 34+ cells treatment. Seven of 15 recipient underwent a second allogeneic HSCT ; 6 of 7 recipient responded to second transplant. Summary/Conclusion: Significant relationship between R/D CMV serostatus at pre-transplant evaluation with graft failure is different finding from the previous studies. However; Second HSCT still seems as a best treatment option in this retrospective review.
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