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

Mohamed A. Kharfan-Dabaja; Ambuj Kumar; Ernesto Ayala; Mahmoud Aljurf; Taiga Nishihori; Rebecca Marsh; Lauri M. Burroughs; Navneet Majhail; A. Samer Al-Homsi; Zaid S. Al-Kadhimi; Merav Bar; Alice Bertaina; Jaap J. Boelens; Richard Champlin; Sonali Chaudhury; Zachariah DeFilipp; Bhagirathbhai Dholaria; Areej El-Jawahri; Suzanne Fanning; Ellen Fraint; Usama Gergis; Sergio Giralt; Betty K. Hamilton; Shahrukh K. Hashmi; Biljana Horn; Yoshihiro Inamoto; David A. Jacobsohn; Tania Jain; Laura Johnston; Abraham S. Kanate; Ankit Kansagra; Adetola Kassim; Leslie S. Kean; Carrie L. Kitko; Jessica Knight-Perry; Joanne Kurtzberg; Hien Liu; Margaret L. MacMillan; Zahra Mahmoudjafari; Marco Mielcarek; Mohamad Mohty; Arnon Nagler; Eneida Nemecek; Timothy S. Olson; Betul Oran; Miguel Angel Perales; Susan E. Prockop; Michael A. Pulsipher; Iskra Pusic; Marcie L. Riches; Cesar Rodriguez; Rizwan Romee; Gabriela Rondon; Ayman Saad; Nina Shah; Peter J. Shaw; Shalini Shenoy; Jorge Sierra; Julie Talano; Michael R. Verneris; Paul Veys; John E. Wagner; Bipin N. Savani; Mehdi Hamadani; Paul A. Carpenter

doi:10.1016/j.jtct.2021.04.007

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

Mohamed A. Kharfan-Dabaja, Ambuj Kumar, Ernesto Ayala, Mahmoud Aljurf, Taiga Nishihori, Rebecca Marsh, Lauri M. Burroughs, Navneet Majhail, A. Samer Al-Homsi, Zaid S. Al-Kadhimi, Merav Bar, Alice Bertaina, Jaap J. Boelens, Richard Champlin, Sonali Chaudhury, Zachariah DeFilipp, Bhagirathbhai Dholaria, Areej El-Jawahri, Suzanne Fanning, Ellen FraintUsama Gergis, Sergio Giralt, Betty K. Hamilton, Shahrukh K. Hashmi, Biljana Horn, Yoshihiro Inamoto, David A. Jacobsohn, Tania Jain, Laura Johnston, Abraham S. Kanate, Ankit Kansagra, Adetola Kassim, Leslie S. Kean, Carrie L. Kitko, Jessica Knight-Perry, Joanne Kurtzberg, Hien Liu, Margaret L. MacMillan, Zahra Mahmoudjafari, Marco Mielcarek, Mohamad Mohty, Arnon Nagler, Eneida Nemecek, Timothy S. Olson, Betul Oran, Miguel Angel Perales, Susan E. Prockop, Michael A. Pulsipher, Iskra Pusic, Marcie L. Riches, Cesar Rodriguez, Rizwan Romee, Gabriela Rondon, Ayman Saad, Nina Shah, Peter J. Shaw, Shalini Shenoy, Jorge Sierra, Julie Talano, Michael R. Verneris, Paul Veys, John E. Wagner, Bipin N. Savani, Mehdi Hamadani, Paul A. Carpenter

Research output: Contribution to journal › Article › peer-review

64 Scopus citations

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.

Original language	English (US)
Pages (from-to)	642-649
Number of pages	8
Journal	Transplantation and Cellular Therapy
Volume	27
Issue number	8
DOIs	https://doi.org/10.1016/j.jtct.2021.04.007
State	Published - Aug 2021
Externally published	Yes

Keywords

Allogeneic hematopoietic cell transplantation
Donor chimerism
Graft failure
Graft rejection
Hematopoietic recovery

ASJC Scopus subject areas

Immunology and Allergy
Molecular Medicine
Hematology
Cell Biology
Transplantation

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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., ... Carpenter, P. A. (2021). 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. Transplantation and Cellular Therapy, 27(8), 642-649. https://doi.org/10.1016/j.jtct.2021.04.007

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 et al.
In: Transplantation and Cellular Therapy, Vol. 27, No. 8, 08.2021, p. 642-649.

Research output: Contribution to journal › Article › peer-review

Kharfan-Dabaja, MA, Kumar, A, Ayala, E, Aljurf, M, Nishihori, T, Marsh, R, Burroughs, LM, Majhail, N, Al-Homsi, AS, Al-Kadhimi, ZS, Bar, M, Bertaina, A, Boelens, JJ, Champlin, R, Chaudhury, S, DeFilipp, Z, Dholaria, B, El-Jawahri, A, Fanning, S, Fraint, E, Gergis, U, Giralt, S, Hamilton, BK, Hashmi, SK, Horn, B, Inamoto, Y, Jacobsohn, DA, Jain, T, Johnston, L, Kanate, AS, Kansagra, A, Kassim, A, Kean, LS, Kitko, CL, Knight-Perry, J, Kurtzberg, J, Liu, H, MacMillan, ML, Mahmoudjafari, Z, Mielcarek, M, Mohty, M, Nagler, A, Nemecek, E, Olson, TS, Oran, B, Perales, MA, Prockop, SE, Pulsipher, MA, Pusic, I, Riches, ML, Rodriguez, C, Romee, R, Rondon, G, Saad, A, Shah, N, Shaw, PJ, Shenoy, S, Sierra, J, Talano, J, Verneris, MR, Veys, P, Wagner, JE, Savani, BN, Hamadani, M & Carpenter, PA 2021, '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', Transplantation and Cellular Therapy, vol. 27, no. 8, pp. 642-649. https://doi.org/10.1016/j.jtct.2021.04.007

Kharfan-Dabaja MA, Kumar A, Ayala E, Aljurf M, Nishihori T, Marsh R et al. 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. Transplantation and Cellular Therapy. 2021 Aug;27(8):642-649. doi: 10.1016/j.jtct.2021.04.007

Kharfan-Dabaja, Mohamed A. ; Kumar, Ambuj ; Ayala, Ernesto et al. / 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. In: Transplantation and Cellular Therapy. 2021 ; Vol. 27, No. 8. pp. 642-649.

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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.",

keywords = "Allogeneic hematopoietic cell transplantation, Donor chimerism, Graft failure, Graft rejection, Hematopoietic recovery",

author = "Kharfan-Dabaja, {Mohamed A.} and Ambuj Kumar and Ernesto Ayala and Mahmoud Aljurf and Taiga Nishihori and Rebecca Marsh and Burroughs, {Lauri M.} and Navneet Majhail and Al-Homsi, {A. Samer} and Al-Kadhimi, {Zaid S.} and Merav Bar and Alice Bertaina and Boelens, {Jaap J.} and Richard Champlin and Sonali Chaudhury and Zachariah DeFilipp and Bhagirathbhai Dholaria and Areej El-Jawahri and Suzanne Fanning and Ellen Fraint and Usama Gergis and Sergio Giralt and Hamilton, {Betty K.} and Hashmi, {Shahrukh K.} and Biljana Horn and Yoshihiro Inamoto and Jacobsohn, {David A.} and Tania Jain and Laura Johnston and Kanate, {Abraham S.} and Ankit Kansagra and Adetola Kassim and Kean, {Leslie S.} and Kitko, {Carrie L.} and Jessica Knight-Perry and Joanne Kurtzberg and Hien Liu and MacMillan, {Margaret L.} and Zahra Mahmoudjafari and Marco Mielcarek and Mohamad Mohty and Arnon Nagler and Eneida Nemecek and Olson, {Timothy S.} and Betul Oran and Perales, {Miguel Angel} and Prockop, {Susan E.} and Pulsipher, {Michael A.} and Iskra Pusic and Riches, {Marcie L.} and Cesar Rodriguez and Rizwan Romee and Gabriela Rondon and Ayman Saad and Nina Shah and Shaw, {Peter J.} and Shalini Shenoy and Jorge Sierra and Julie Talano and Verneris, {Michael R.} and Paul Veys and Wagner, {John E.} and Savani, {Bipin N.} and Mehdi Hamadani and Carpenter, {Paul A.}",

note = "Publisher Copyright: {\textcopyright} 2021 The American Society for Transplantation and Cellular Therapy",

year = "2021",

month = aug,

doi = "10.1016/j.jtct.2021.04.007",

language = "English (US)",

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T2 - A Report on Behalf of the American Society for Transplantation and Cellular Therapy

AU - Kharfan-Dabaja, Mohamed A.

AU - Kumar, Ambuj

AU - Ayala, Ernesto

AU - Aljurf, Mahmoud

AU - Nishihori, Taiga

AU - Marsh, Rebecca

AU - Burroughs, Lauri M.

AU - Majhail, Navneet

AU - Al-Homsi, A. Samer

AU - Al-Kadhimi, Zaid S.

AU - Bar, Merav

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AU - Boelens, Jaap J.

AU - Champlin, Richard

AU - Chaudhury, Sonali

AU - DeFilipp, Zachariah

AU - Dholaria, Bhagirathbhai

AU - El-Jawahri, Areej

AU - Fanning, Suzanne

AU - Fraint, Ellen

AU - Gergis, Usama

AU - Giralt, Sergio

AU - Hamilton, Betty K.

AU - Hashmi, Shahrukh K.

AU - Horn, Biljana

AU - Inamoto, Yoshihiro

AU - Jacobsohn, David A.

AU - Jain, Tania

AU - Johnston, Laura

AU - Kanate, Abraham S.

AU - Kansagra, Ankit

AU - Kassim, Adetola

AU - Kean, Leslie S.

AU - Kitko, Carrie L.

AU - Knight-Perry, Jessica

AU - Kurtzberg, Joanne

AU - Liu, Hien

AU - MacMillan, Margaret L.

AU - Mahmoudjafari, Zahra

AU - Mielcarek, Marco

AU - Mohty, Mohamad

AU - Nagler, Arnon

AU - Nemecek, Eneida

AU - Olson, Timothy S.

AU - Oran, Betul

AU - Perales, Miguel Angel

AU - Prockop, Susan E.

AU - Pulsipher, Michael A.

AU - Pusic, Iskra

AU - Riches, Marcie L.

AU - Rodriguez, Cesar

AU - Romee, Rizwan

AU - Rondon, Gabriela

AU - Saad, Ayman

AU - Shah, Nina

AU - Shaw, Peter J.

AU - Shenoy, Shalini

AU - Sierra, Jorge

AU - Talano, Julie

AU - Verneris, Michael R.

AU - Veys, Paul

AU - Wagner, John E.

AU - Savani, Bipin N.

AU - Hamadani, Mehdi

AU - Carpenter, Paul A.

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N2 - 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.

AB - 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.

KW - Allogeneic hematopoietic cell transplantation

KW - Donor chimerism

KW - Graft failure

KW - Graft rejection

KW - Hematopoietic recovery

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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

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Keywords

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