Table 3 Selected studies using second transplant for patients with graft failure

Nagler et al. [69]

243

Malignant

Same donor in 49% and different in 51%

RIC in 80.4% and MAC in 19.6%

48 days (28–120)

PTCY: 27.7%

In vivo T-cell depletion: 49.1%

Ex vivo T-cell depletion: 13.5%

-

73.7%

5-year: 30.7%

Suma et al. [64]

10

Malignant

UCB

FLU /CY /TBI

38.5 days (35–46)

Tacrolimus /MMF

UCB

80%

1-year: 50.0%

Sun et al. [32]

13

Malignant

Different HID

FLU/CY

49 days (35–120)

Basixilimab/cyclosporine A/MMF

PBSC/BMSC

100%

1-year: 56.6%

Subburaj et al. [70]

4

Malignant/

non-malignant

HID/ same donor (1 patient) or another haplo family donor (3 patients)

FLU/CY

54 days (45–65)

Tacrolimus /MMF

PBSC

100%

With a median follow up time of 28.5 months (range 1 –69 months): 50%

Sabrina Giammarco et al. [71]

20

Malignant

HID/ same donor (13 patients) or another haplo family donor (6 patients)

Baltimore protocol

42 days (34–82)

PTCY,/Cyclosporine/MMF

PBSC

74%

1-year: 66%

Harada et al. [72]

699

Malignant/

non-malignant

HID/UCB

MAC (N = 16)

RIC (N = 528)

NMA (N = 160)

HID: 42 days (17–757)

UCB: 42 days (19–2250)

CNI + MTX/MMF/ prednisolone/ ATG

UCB

HID: 79.7%

UCB: 52.5%

1-year OS, 33.1 vs. 34.6% for the HID and UCB groups

Kongtim et al. [53]

31

Malignant

HID/ 7/19 (36.8%) from the same HID

FLU/CY/TBI

48 days (27–147)

PTCY,/Tacrolimus /MMF

-

87.5%

FLU-CY-TBI regimen: 42.9%

Other regimens: 6.7%

(P = 0.043)

Pedro Prata et al. [67]

24

Malignant/

non-malignant

HID/ same donor (N = 4) Different HID (N = 20)

FLU-based RIC

63 days (39 to 98)

PTCY/Cyclosporine ± MMF

PBSC/BMSC

79%

1-year: 56% (95% CI, 38% to 81%)

Mochizuki et al. [73]

6

Malignant

Same donor (N = 1)

Different donor (N = 5)

RIC:

FLU/ATG

FLU/MEL/ATG

37.5 days (28–126)

Tacrolimus/MTX/Prednisolone

BMSC (N = 5)

PBSC (N = 1)

All but one patient

4 are alive and in sustained remission for more than 4 years at the time of the last follow-up

Christelle Ferrà [27]

49

Malignant/

non-malignant

Same donor (N = 38)

Different donor (N = 37) autologous back-up (N = 5)

FLU /ATG

CY/ATG

ATG

69 days (24–652)

Cyclosporine,

Cyclosporine/MMF

Cyclosporine/Prednisone

Cyclosporine/MTX

Tacrolimus/MTX

CD34 + selection

No prophylaxis

PBSC/BMSC/UCB

80% (95% CI: 69–91)

5-year probability of survival: 31% (95%CI: 18%-44%)

Singh et al. [61]

12

Malignant

HID/UCB

FLU /CY/TBI

FLU/BU

FLU /CY/Alemtuzumab

41 days (31–64)

Tacrolimus/Sirolimius

Cyclosporine /MMF

Tacrolimus/MTX/ATG

PTCY /Tacrolimus/ MMF

UCB/BMSC

9/12

3-year OS: 37%

Kato et al. [50]

102

Malignant/

non-malignant

MMD/UCB

FLU/CY

MEL/ATG /Irradiation

39.5 days (18–59)

-

-

55.7 ± 5.0%

1-year: 53.3 ± 5.0%

Fuji et al. [54]

220

Malignant/

non-malignant

1-locus mismatched donor, HID, Matched donor

None (N = 13)

MAC (N = 5)

RIC (N = 122)

NMA (N = 77)

Time from graft failure to transplantation:11 (0–89) days

-

CB (N = 180)

BMSC (N = 16)

PBSC (N = 24)

UCB: 39%

PBSCs: 71%

BMSC: 75%

1-year OS was 58% with PBSCs, 38% with BMSC, and 28% with UCB

Lang et al. [66]

11

Malignant/

non-malignant

HID/ different donor

TLI (TBI) /FLU/ATG and/or OKT3 (N = 10)

One patient received CY instead of irradiation,

TT was added in 6 patients

40 days (31–106)

CD3/CD19 depleted grafts;

Patients, whose grafts contained more than 2.5 × 10⁴ T cells/kg bodyweight received pharmacological GvHD prophylaxis with MMF

PBSC

100%

8/11 patients are disease free (median follow up 1.9 years; 1 year-EFS = 72%)

Chewning et al. [51]

16

Malignant/non-malignant

Same donor (N = 6)

Different donor (N = 10)

Related donor (N = 11)

Unrelated donor (N = 5)

Matched donor (N = 5)

Mismatched donor (N = 11)

FLU (N = 1)

FLU/CY (N = 9)

FLU/TT (N = 5)

45 days (31–85)

eATG (N = 8)

rATG (N = 3)

Alemtuzumab (Campath) (N = 3 p)

TCD (N = 2)

Cyclosporine A ± MMF or steroids (N = 6)

MTX (N = 1)

Steroids alone (N = 1)

BMSC (N = 3)

PBSC (N = 13)

100%

3-year: 35%