Cord blood transplantation is associated with good outcomes in secondary Acute Myeloid Leukaemia in first remission

J Intern Med. 2019 Apr;285(4):446-454. doi: 10.1111/joim.12870. Epub 2019 Jan 18.

Abstract

Background: We conducted a retrospective survey within the European Society for Blood and Marrow Transplantation (EBMT) registry to assess the outcomes of cord blood transplantation (CBT) in secondary acute myeloid leukaemia (sAML).

Methods: Inclusion criteria consisted of ≥18 years of age, sAML, first CBT between 2002 and 2016, and either first complete remission (CR) or active disease at CBT.

Results: One hundred forty-six patients met the study inclusion criteria. Status at transplantation was first CR (n = 97), primary refractory sAML (n = 30) or relapsed (n = 19) sAML. Neutrophil engraftment was achieved in 118 patients while the remaining 25 patients (17%) failed to engraft. This includes 13% of patients transplanted in first CR versus 30% of those transplanted with active disease (P = 0.008). Two-year incidences of relapse were 25% in first CR patients versus 36% in those with advanced disease (P = 0.06) while 2-year incidences of nonrelapse mortality were 35% and 49% (P = 0.03), respectively. At 2-year overall survival, leukaemia-free survival and graft-versus-host disease (GVHD)-free relapse-free survival were 42% vs. 19% (P < 0.001), 40% vs. 16% (P < 0.001), and 26% vs. 12% (P = 0.002) in first CR patients versus those with advanced disease, respectively.

Conclusions: We report here the first study of CBT in a large cohort of sAML patients. Main observation was that CBT rescued approximately 40% of patients with sAML in first CR.

Keywords: cord blood transplantation; graft-versus-host disease; graft-versus-leukaemia effects; secondary acute myeloid leukaemia.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cord Blood Stem Cell Transplantation*
  • Disease-Free Survival
  • Female
  • Graft vs Host Disease / epidemiology
  • Humans
  • Leukemia, Myeloid, Acute / therapy*
  • Male
  • Middle Aged
  • Recurrence
  • Remission Induction
  • Treatment Outcome
  • Young Adult