Poor graft function - causes and potential solutions

Introduction. Poor graft function is one of the most severe complications after allogeneic hematopoietic stem cell transplantation, which manifests as pancytopenia/cytopenia in blood count, with presence complete or incomplete donor chimerism. There are three entities weakness: 1. poor function: pancytopenia chimerism, 2. failure: incomplete, i.e., mixed chimerism and 3. rejection: progressive decline Definition. diagnosed (hemoglobin < 70 g/L, absolute neutrophil count 0.5 x 109/L, platelets 20 109/L) for 3 consecutive days from D+28, excluding versus host disease relapse, function, failure. Risk factors therapeutic principles. The common risk a small dose CD34+ cells transplant, disease, cytomegalovirus infection, donor-specific antibodies, high serum ferritin, iron overload, well splenomegaly. Pathogenetic mechanisms development still not fully elucidated. role microenvironment patient?s bone marrow also important, disorders immune system Therapeutic options overcoming this complication include using selected ?stem boost?, mesenchymal cells, newer medical agents (N-acetyl cysteine, atorvastatin, thrombopoietin receptor agonists). Conclusion. type defined relation to percentage necessary planning further treatment strategy.