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 - Funding Information:
The authors thank all the physicians and data managers of the centers, who contributed to the collection of data on transplantation for the Japanese Data Center for Hematopoietic Cell Transplantation and the Transplant Registry Unified Management Program 2. We would like to express our gratitude to the Japan Society of Clinical Research for their support.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2022/4
Y1 - 2022/4
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
VL - 36
SP - 1132
EP - 1138
JO - Leukemia
JF - Leukemia
IS - 4
ER -
