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.

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.

Recommended Citation

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; and Carpenter, Paul A., "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." (2021). Department of Medical Oncology Faculty Papers. Paper 148.
https://jdc.jefferson.edu/medoncfp/148

Creative Commons License

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

PubMed ID

34304802

Language

English