Primary Graft Failure After Umbilical Cord Blood Transplant Rescued by Parental Haplocompatible Stem Cell Transplantation

Graft failure and aplasia are known complications of umbilical cord blood (UCB) hematopoietic stem cell transplantation (HSCT). In the absence of a second HSCT, graft failure is generally a fatal complication due to overwhelming infection. We describe 2 children with primary graft failure and lifie-threatening infections after UCB HSCT who were rescued by the use of related haplocompatible T-cell-depleted peripheral blood stem cell transplants. The rapid availability of haplocompatible donors and the brisk neutrophil recovery after haplocompatible peripheral blood stem cell transplant with high numbers of CD34(+) cells make this an attractive rescue strategy for patients with graft failure after UCB HSCT.