Comparing cord blood transplantation and matched related donor transplantation in non-remission acute myeloid leukemia

Cord blood transplantation (CBT) is an alternative donor transplantation method and has the advantages of rapid availability and the possibility of inducing a more potent graft-versus-leukemia effect, leading to a lower relapse rate for patients with non-remission relapse and refractory acute myeloi...

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Published in:	Leukemia 2022-04, Vol.36 (4), p.1132-1138
Main Authors:	Shimomura, Yoshimitsu, Sobue, Tomotaka, Hirabayashi, Shigeki, Kondo, Tadakazu, Mizuno, Shohei, Kanda, Junya, Fujino, Takahiro, Kataoka, Keisuke, Uchida, Naoyuki, Eto, Tetsuya, Miyakoshi, Shigesaburo, Tanaka, Masatsugu, Kawakita, Toshiro, Yokoyama, Hisayuki, Doki, Noriko, Harada, Kaito, Wake, Atsushi, Ota, Shuichi, Takada, Satoru, Takahashi, Satoshi, Kimura, Takafumi, Onizuka, Makoto, Fukuda, Takahiro, Atsuta, Yoshiko, Yanada, Masamitsu
Format:	Article
Language:	eng
Subjects:	Acute myeloid leukemia Adult Antigens Blood Confidence intervals Cord blood Cord Blood Stem Cell Transplantation - methods Graft vs Host Disease Graft-versus-leukemia reaction Hematopoietic Stem Cell Transplantation - methods Histocompatibility antigen HLA Humans Leukemia Leukemia, Myeloid, Acute - therapy Leukocytes Matching Myeloid leukemia Remission Remission (Medicine) Retrospective Studies Stem cell transplantation Transplantation Transplantation Conditioning - methods
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Summary:	Cord blood transplantation (CBT) is an alternative donor transplantation method and has the advantages of rapid availability and the possibility of inducing a more potent graft-versus-leukemia effect, leading to a lower relapse rate for patients with non-remission relapse and refractory acute myeloid leukemia (R/R AML). This study aimed to investigate the impact of CBT, compared to human leukocyte antigen-matched related donor transplantation (MRDT). This study included 2451 adult patients with non-remission R/R AML who received CBT (1738 patients) or MRDT (713 patients) between January 2009 and December 2018. Five-year progression-free survival (PFS) and the prognostic impact of CBT were evaluated using a propensity score (PS) matching analysis. After PS matching, the patient characteristics were well balanced between the groups. The five-year PFS was 25.2% (95% confidence interval [CI]: 21.2-29.5%) in the CBT group and 18.1% (95% CI: 14.5-22.0%) in the MRDT group (P = 0.009). The adjusted hazard ratio (HR) was 0.83 (95% CI: 0.69-1.00, P = 0.045); this was due to a more pronounced decrease in the relapse rate (HR: 0.78, 95% CI: 0.69-0.89, P
ISSN:	0887-6924 1476-5551