Authors

Mohamed A. Kharfan-Dabaja, Mayo Clinic
Ambuj Kumar, University of South Florida
Ernesto Ayala, Mayo Clinic
Mahmoud Aljurf, King Faisal Specialist Hospital and Research Centre
Taiga Nishihori, Moffitt Cancer Center
Rebecca Marsh, Cincinnati Children's Hospital Medical Center
Lauri M. Burroughs, Fred Hutchinson Cancer Research Center,
Navneet Majhail, Cleveland Clinic
A. Samer Al-Homsi, NYU Langone Health
Zaid S. Al-Kadhimi, University of Nebraska Medical Center
Merav Bar, Fred Hutchinson Cancer Research Center
Alice Bertaina, Stanford University
Jaap J. Boelens, Memorial Sloan Kettering Cancer Center
Richard Champlin, The University of Texas MD Anderson Cancer Center
Sonali Chaudhury, Ann and Robert H. Lurie Children's Hospital of Chicago
Zachariah DeFilipp, Massachusetts General Hospital
Bhagirathbhai Dholaria, Vanderbilt University Medical Center
Areej El-Jawahri, Massachusetts General Hospital
Suzanne Fanning, University of South Carolina School of Medicine
Ellen Fraint, Memorial Sloan Kettering Cancer Center
Usama Gergis, Thomas Jefferson UniversityFollow
Sergio Giralt, Memorial Sloan Kettering Cancer Center; Weill Cornell Medical College
Betty K. Hamilton, Cleveland Clinic
Shahrukh K. Hashmi, Sheikh Shakhbout Medical City
Biljana Horn, University of Florida; UF Health Shands Children's Hospital
Yoshihiro Inamoto, National Cancer Center Hospital, Tokyo
David A. Jacobsohn, Children's National Medical Center
Tania Jain, Johns Hopkins University School of Medicine
Laura Johnston, Stanford University School of Medicine
Abraham S. Kanate, West Virginia University
Ankit Kansagra, UT Southwestern Medical Center
Adetola Kassim, Vanderbilt University Medical Center
Leslie S. Kean, Boston Children's Hospital; Dana-Farber Cancer Institute
Carrie L. Kitko, Vanderbilt University Medical Center
Jessica Knight-Perry, University of Colorado School of Medicine
Joanne Kurtzberg, Duke University School of Medicine
Hien Liu, Moffitt Cancer Center
Margaret L. MacMillan, University of Minnesota Medical School
Zahra Mahmoudjafari, University of Kansas Health System
Marco Mielcarek, Fred Hutchinson Cancer Research Center
Mohamad Mohty, Sorbonne Université
Arnon Nagler, Chaim Sheba Medical Center
Eneida Nemecek, Oregon Health & Science University
Timothy S. Olson, Children's Hospital of Philadelphia
Betul Oran, The University of Texas MD Anderson Cancer Center
Miguel-Angel Perales, Memorial Sloan Kettering Cancer Center; Weill Cornell Medical College
Susan E. Prockop, Memorial Sloan Kettering Cancer Center
Michael A. Pulsipher, USC Keck School of Medicine
Iskra Pusic, Washington University School of Medicine
Marcie L. Riches, University of North Carolina at Chapel Hill
Cesar Rodriguez, Wake Forest University School of Medicine
Rizwan Romee, Harvard Medical School
Gabriela Rondon, The University of Texas MD Anderson Cancer Center
Ayman Saad, The Ohio State University
Nina Shah, University of California San Francisco
Peter J. Shaw, The Children's Hospital at Westmead
Shalini Shenoy, Washington University School of Medicine
Jorge Sierra, Josep Carreras Leukemia Research Institute
Julie Talano, Medical College of Wisconsin
Michael R. Verneris, University of Colorado School of Medicine
Paul Veys, University College London
John E. Wagner, University of Minnesota Medical School
Bipin N. Savani, Vanderbilt University Medical Center
Mehdi Hamadani, Medical College of Wisconsin
Paul A. Carpenter, Fred Hutchinson Cancer Research Center

Document Type

Article

Publication Date

7-23-2021

Comments

This article is the authors’ final published version in Transplantation and Cellular Therapy, Volume 27, Issue 8, July 2021, Pages 642-649.

The published version is available at https://doi.org/10.1016/j.jtct.2021.04.007. Copyright © Kharfan-Dabaja et al.

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.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

34304802

Language

English

Included in

Oncology Commons

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