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Autografting

The harvest and use of autologous back-up grafts for graft failure or severe GVHD after allogeneic hematopoietic stem cell transplantation: a survey of the European Group for Blood and Marrow Transplantation

Bone Marrow Transplantation volume 42, pages 739–742 (2008)Cite this article

Abstract

Autologous hematopoietic stem cells (HSCs) harvested as back-up prior to allogeneic hematopoietic SCT (HSCT) may potentially be useful in the treatment of graft failure or in cases with severe GVHD. Here, we studied the general policies and indications for autologous back-up harvest among the European Group for Blood and Marrow Transplantation centers in the year 2003. The outcome of patients receiving autologous back-up transfusion between 1998 and 2002 was evaluated retrospectively. The responses from 94 centers showed that 48 centers had a general policy with variable indications for autologous back-up harvest. Thirty-five patients with graft failure (25), GVHD (8) or relapse (2) retransplanted with autologous back-ups were reported. Autologous back-up transfusion was performed at a median of 35 days (patients with graft failure) or 90 days (patients with GVHD) after allogeneic HSCT. Within 100 days after autologous HSCT, 21 patients died from treatment-related complications (19) or relapse (2). Estimated overall survival at 1 year was 16% (95% CI 0–32%) for patients treated for graft failure and 13% (95% CI 0–37%) for GVHD patients. In conclusion, our data demonstrate that the indication for autologous back-up harvests is limited and that general storage and use cannot be recommended unless in selected prospective studies.

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Acknowledgements

We thank all the physicians mentioned in the appendix and their teams for referring their patients' data to the EBMT Chronic Leukaemia Working Party registry.

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Authors and Affiliations

  1. Department of Medicine, Hematology and Oncology, University of Muenster, Muenster, Germany

    M Stelljes & J Kienast

  2. Department of Medical Statistics, Leiden University, Leiden, The Netherlands

    A van Biezen

  3. Department of Bone Marrow Transplantation, Hadassah University Hospital, Jerusalem, Israel

    S Slavin

  4. Department of Haematology, Imperial College, Hammersmith Hospital, London, UK

    E Olavarria

  5. University Department of Haematology, Royal Liverpool University Hospital, Liverpool, UK

    R E Clark

  6. Division of Hematology, Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel Hashomer, Israel

    A Nagler

  7. Department of Hematology and Oncology, University Hospital Pilsen, Pilsen, Czech Republic

    V Koza

  8. Department of Haematology and Oncology, University of Leipzig, Leipzig, Germany

    D Niederwieser

  9. Department of Haematology, University Medical Centre Radboud, Nijmegen, The Netherlands

    T de Witte

  10. Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland

    T Ruutu

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  1. M Stelljes
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  2. A van Biezen
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  6. A Nagler
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  7. V Koza
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  8. J Kienast
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  9. D Niederwieser
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Consortia

for the complications subcommittee of the Chronic Leukemia Working Party

Corresponding author

Correspondence to M Stelljes.

Appendix

Appendix

S Slavin, Hadassah University Hospital, Jerusalem, Israel (CIC 258); E Olavarria, Hammersmith Hospitals NHS Trust, London, UK (CIC 205); R Foa, Universita‘ ‘La Sapienza’, Roma, Italy (CIC 232); L Brinch, Rikshospitalet, Oslo, Norway (CIC 235); G Dini, Istituto Giannina Gaslini, Genova, Italy (CIC 274); G Saglio, Ospedale San Luigi Orbassano, Orbassano, Italy (CIC 378); RE Clark, Royal Liverpool University Hospital, Liverpool, UK (CIC 501); C Crawley, Addenbrooke's Hospital, Cambridge, UK (CIC 566); P Corradini, Istituto Nazionale Tumori, Milano, Italy (CIC 616); WE Berdel, University of Muenster, Department of Medicine, Muenster, Germany (CIC 680); T O'Brien, Sydney Children's Hospital, Sydney, Australia (CIC 698); P Shaw, The Children's Hospital at Westmead, Sydney, Australia (CIC 711); V Koza, Faculty Hospital, Pilsen, Czech Republic (CIC 718); A Nagler, Chaim Sheba Medical Center, Tel Hashomer, Israel (CIC 754); E Liakopoulou, Christie Hospital, Manchester, UK (CIC 780) and F Argiolu, Ospedale per le Microcitemie, Cagliari, Italy (CIC 812).

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Stelljes, M., van Biezen, A., Slavin, S. et al. The harvest and use of autologous back-up grafts for graft failure or severe GVHD after allogeneic hematopoietic stem cell transplantation: a survey of the European Group for Blood and Marrow Transplantation. Bone Marrow Transplant 42, 739–742 (2008). https://doi.org/10.1038/bmt.2008.254

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