Standardizing Definitions of Hematopoietic Recovery, Graft Rejection, Graft Failure, Poor Graft Function, and Donor Chimerism in Allogeneic Hematopoietic Cell Transplantation: A Report on Behalf of the American Society for Transplantation and Cellular Therapy.

Kharfan-Dabaja, Mohamed A

Kumar, Ambuj

Ayala, Ernesto

Aljurf, Mahmoud

Nishihori, Taiga

Marsh, Rebecca

Burroughs, Lauri M

Majhail, Navneet

Al-Homsi, A Samer

Al-Kadhimi, Zaid S

Bar, Merav

Bertaina, Alice

Boelens, Jaap J

Champlin, Richard

Chaudhury, Sonali

DeFilipp, Zachariah

Dholaria, Bhagirathbhai

El-Jawahri, Areej

Fanning, Suzanne

Fraint, Ellen

Gergis, Usama

Giralt, Sergio

Hamilton, Betty K

Hashmi, Shahrukh K

Horn, Biljana

Inamoto, Yoshihiro

Jacobsohn, David A

Jain, Tania

Johnston, Laura

Kanate, Abraham S

Kansagra, Ankit

Kassim, Adetola

Kean, Leslie S

Kitko, Carrie L

Knight-Perry, Jessica

Kurtzberg, Joanne

Liu, Hien

MacMillan, Margaret L

Mahmoudjafari, Zahra

Mielcarek, Marco

Mohty, Mohamad

Nagler, Arnon

Nemecek, Eneida

Olson, Timothy S

Oran, Betul

Perales, Miguel-Angel

Prockop, Susan E

Pulsipher, Michael A

Pusic, Iskra

Riches, Marcie L

Rodriguez, Cesar

Romee, Rizwan

Rondon, Gabriela

Saad, Ayman

Shah, Nina

Shaw, Peter J

Shenoy, Shalini

Sierra, Jorge

Talano, Julie

Verneris, Michael R

Veys, Paul

Wagner, John E

Savani, Bipin N

Hamadani, Mehdi

Carpenter, Paul A

2022-03-24T13:59:37Z

2022-03-24T13:59:37Z

2021-08

2022-03-24T13:59:36Z

Allogeneic hematopoietic cell transplantation (allo-HCT) is potentially curative for certain hematologic malignancies and nonmalignant diseases. The field of allo-HCT has witnessed significant advances, including broadening indications for transplantation, availability of alternative donor sources, less toxic preparative regimens, new cell manipulation techniques, and novel GVHD prevention methods, all of which have expanded the applicability of the procedure. These advances have led to clinical practice conundrums when applying traditional definitions of hematopoietic recovery, graft rejection, graft failure, poor graft function, and donor chimerism, because these may vary based on donor type, cell source, cell dose, primary disease, graft-versus-host disease (GVHD) prophylaxis, and conditioning intensity, among other variables. To address these contemporary challenges, we surveyed a panel of allo-HCT experts in an attempt to standardize these definitions. We analyzed survey responses from adult and pediatric transplantation physicians separately. Consensus was achieved for definitions of neutrophil and platelet recovery, graft rejection, graft failure, poor graft function, and donor chimerism, but not for delayed engraftment. Here we highlight the complexities associated with the management of mixed donor chimerism in malignant and nonmalignant hematologic diseases, which remains an area for future research. We recognize that there are multiple other specific, and at times complex, clinical scenarios for which clinical management must be individualized.

S2666-6367(21)00831-9

2666-6375

2666-6367

https://hdl.handle.net/10161/24707

eng

Elsevier BV

Transplantation and cellular therapy

10.1016/j.jtct.2021.04.007

Humans

Transplantation Conditioning

Hematopoietic Stem Cell Transplantation

Transplantation, Homologous

Graft Rejection

Chimerism

Adult

Child

United States

Standardizing Definitions of Hematopoietic Recovery, Graft Rejection, Graft Failure, Poor Graft Function, and Donor Chimerism in Allogeneic Hematopoietic Cell Transplantation: A Report on Behalf of the American Society for Transplantation and Cellular Therapy.

Journal article

Kurtzberg, Joanne|0000-0002-3370-0703

642

649

8

Duke

School of Medicine

Clinical Science Departments

Institutes and Centers

Pathology

Pediatrics

Duke Cancer Institute

Institutes and Provost's Academic Units

Initiatives

Duke Innovation & Entrepreneurship

Pediatrics, Transplant and Cellular Therapy

Published

27