TY - JOUR
T1 - Comparing cord blood transplantation and matched related donor transplantation in non-remission acute myeloid leukemia
AU - Shimomura, Yoshimitsu
AU - Sobue, Tomotaka
AU - Hirabayashi, Shigeki
AU - Kondo, Tadakazu
AU - Mizuno, Shohei
AU - Kanda, Junya
AU - Fujino, Takahiro
AU - Kataoka, Keisuke
AU - Uchida, Naoyuki
AU - Eto, Tetsuya
AU - Miyakoshi, Shigesaburo
AU - Tanaka, Masatsugu
AU - Kawakita, Toshiro
AU - Yokoyama, Hisayuki
AU - Doki, Noriko
AU - Harada, Kaito
AU - Wake, Atsushi
AU - Ota, Shuichi
AU - Takada, Satoru
AU - Takahashi, Satoshi
AU - Kimura, Takafumi
AU - Onizuka, Makoto
AU - Fukuda, Takahiro
AU - Atsuta, Yoshiko
AU - Yanada, Masamitsu
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2021
Y1 - 2021
N2 - 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 < 0.001) than an increase in the NRM (1.42, 1.15–1.76, P = 0.001). In this population, CBT was associated with a better 5-year PFS than MRDT after allogeneic HSCT.
AB - 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 < 0.001) than an increase in the NRM (1.42, 1.15–1.76, P = 0.001). In this population, CBT was associated with a better 5-year PFS than MRDT after allogeneic HSCT.
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U2 - 10.1038/s41375-021-01474-0
DO - 10.1038/s41375-021-01474-0
M3 - Article
C2 - 34815516
AN - SCOPUS:85119652430
SN - 0887-6924
JO - Leukemia
JF - Leukemia
ER -
