Outcome of autologous rescue after failed engraftment of allogeneic marrow

J. Mehta*, R. Powles, S. Singhal, C. Horton, J. Treleaven

*Corresponding author for this work

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Ten patients experiencing primary graft failure after allogeneic bone marrow transplantation received autologous marrow or blood cells as hematopoietic rescue 21-40 (median 22.5) days after the original transplant after which immunosuppression with cyclosporine was tapered off rapidly. The leukocyte count at the time of rescue was 0.1-0.3 x 109/l with <0.1 x 109/l neutrophils. The clinical course was uneventful after rescue with hematologic recovery to 0.5 x 109/l neutrophils occurring 9-61 days (median 20) later in nine patients, and to 50 x 109/l platelets 17-595 days (median 40) later in eight patients. No patient had a life-threatening infection at the time of or after rescue. No patient experienced acute graft-versus-host disease. Four patients with acute leukemia had recurrent disease 46-117 days after autologous rescue, and died of relapse. Five patients with acute leukemia are alive in continuous remission at 270-3382 days, and one patient with chronic myeloid leukemia is alive in hematologic remission at 228 days. We conclude that infusion of back-up autologous cells can prevent the immediate infectious consequences of primary allogeneic graft failure through consistent myeloid recovery, and may result in long-term survival of patients with good-risk disease.

Original languageEnglish (US)
Pages (from-to)213-217
Number of pages5
JournalBone Marrow Transplantation
Volume17
Issue number2
StatePublished - Feb 1996

Keywords

  • Allogeneic bone marrow transplantation
  • Autologous bone marrow transplantation
  • Graft failure
  • Graft rejection
  • Graft-versus-leukemia

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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