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- W2113819692 abstract "Following allogeneic hematopoietic stem cell transplantation (HSCT) graft failure is a major complication, which markedly decreases overall survival. Several risk factors for graft failure have been reported, such as reduced intensity conditioning, HLA-mismatch, T-cell depleted grafts etc. However, in the early post-transplant period following myeloablative conditioning there is a lack of tools for early detection of patients at risk for subsequent graft failure. For this purpose, we retrospectively evaluated all patients who after myeloablative conditioning received peripheral blood cells (PBSC) at our centre during 1995 to 2007 (n=219). The indications for transplantation were: AML (43%), ALL (23%), CML (17%), myelodysplastic syndrome (6%), lymphoma (5%), metabolic disorders (4%), and multiple myeloma (2%). Graft failure was defined as absolute neutrophil count (ANC) <0.5 × 109/L or less than 5% donor cell chimerism. Moreover, primary graft failure was set to day 28 post-transplant, and patients who died prior to that day were excluded from further analyses. Three patients experienced graft failure within 100 days post-transplant (2 primary and 1 secondary graft failure), which means that the incidence of graft failure was 1.4%. In univariate analysis, there was a tendency that the total nucleated cell dose was associated with primary graft failure (P=0.06). In contrast, when analyzing risk factors for graft failure within 100 days post-transplant the total nucleated cell dose seemed to be unimportant (P=0.17). Interestingly, in subanalyses the risk of graft failure within 100 days post-transplant was markedly increased in those patients who still had an ANC less than 0.2 × 109/L at day 16 post-transplant (OR=30, P<0.01). In conclusion, we suggest that in patients with less than 0.2 × 109/L in ANC 16 days post-transplant one must consider interventions to avoid subsequent graft failure. For this purpose, strategies such as administration of hematopoietic growth factors (e.g. G-CSF) or donor lymphocyte infusions need further evaluation." @default.
- W2113819692 created "2016-06-24" @default.
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- W2113819692 date "2010-02-01" @default.
- W2113819692 modified "2023-10-17" @default.
- W2113819692 title "Absolute Neutrophil Count Less Than 0.2 × 109/L On Day Sixteen Post-Transplant Markedly Increases The Risk Of Graft Failure" @default.
- W2113819692 doi "https://doi.org/10.1016/j.bbmt.2009.12.391" @default.
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