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 Guidelines

  

Authors:	Kharfan-Dabaja, M. A.; Kumar, A.; Ayala, E.; Aljurf, M.; Nishihori, T.; Marsh, R.; Burroughs, L. M.; Majhail, N.; Al-Homsi, A. S.; Al-Kadhimi, Z. S.; Bar, M.; Bertaina, A.; Boelens, J. J.; Champlin, R.; Chaudhury, S.; DeFilipp, Z.; Dholaria, B.; El-Jawahri, A.; Fanning, S.; Fraint, E.; Gergis, U.; Giralt, S.; Hamilton, B. K.; Hashmi, S. K.; Horn, B.; Inamoto, Y.; Jacobsohn, D. A.; Jain, T.; Johnston, L.; Kanate, A. S.; Kansagra, A.; Kassim, A.; Kean, L. S.; Kitko, C. L.; Knight-Perry, J.; Kurtzberg, J.; Liu, H.; MacMillan, M. L.; Mahmoudjafari, Z.; Mielcarek, M.; Mohty, M.; Nagler, A.; Nemecek, E.; Olson, T. S.; Oran, B.; Perales, M. A.; Prockop, S. E.; Pulsipher, M. A.; Pusic, I.; Riches, M. L.; Rodriguez, C.; Romee, R.; Rondon, G.; Saad, A.; Shah, N.; Shaw, P. J.; Shenoy, S.; Sierra, J.; Talano, J.; Verneris, M. R.; Veys, P.; Wagner, J. E.; Savani, B. N.; Hamadani, M.; Carpenter, P. A.
Title:	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
Abstract:	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. © 2021 The American Society for Transplantation and Cellular Therapy
Keywords:	practice guideline; graft failure; graft rejection; allogeneic hematopoietic cell transplantation; hematopoietic recovery; donor chimerism
Journal Title:	Transplantation and Cellular Therapy
Volume:	27
Issue:	8
ISSN:	2666-6375
Publisher:	Elsevier Inc.
Date Published:	2021-08-01
Start Page:	642
End Page:	649
Language:	English
DOI:	10.1016/j.jtct.2021.04.007
PUBMED:	34304802
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85111026486&doi=10.1016%2fj.jtct.2021.04.007&partnerID=40&md5=e32042627ce046b7d78269999f1d5aa1
Notes:	Article -- Export Date: 1 September 2021 -- Source: Scopus

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