Failure to engraft

Engraftment means that the donated stem cells take up residence in the child's bones and begin to produce healthy blood cells. When a child has received HLA-matched marrow from a sibling, engraftment failure occurs in less than 5 percent of these children. In contrast, when children have received marrow from partially HLA-matched family members or from unrelated donors, failure of engraftment (graft rejection) is more frequent, unless more intensive conditioning regimens are used. The pace of engraftment depends upon the stem cell source, stem cell dose, and medical complications that may be present.

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