I've used it in combination. No issues, the only things are that it shrinks, ravels very easily, so pre-wash one or two times before cutting out the pattern. I did machine stitch around my fabric before washing to cut down on the fraying,raveling since it is so loosely woven. The only other thing is if you are planning on hand quilting as IAmCatOwned stated above, my normal needle size was a struggle(flannel backed as well) so I played around with my needles to find the one that wasn't so hard to push through. Tying one is not as bad. I am just starting out machine quilting, and haven't used combination fabrics yet, so I can't comment on that.Good luck with your project.