Patients with refractory or relapsed acute myeloid leukemia (AML) had better outcomes when undergoing allogeneic hematopoietic cell transplantation (allo-HCT) than umbilical cord blood transplantation (CBT), according to a study from Eurocord, the Acute Leukemia Working Party, and the Cord Blood Committee of the Cellular Therapy and Immunobiology Working Party of the European Society of Blood Marrow Transplantation (EBMT).1

The study looked at outcomes among 2963 patients with active disease who underwent cord blood transplant, 10/10 human leukocyte antigen (HLA)-matched unrelated allo-HCT, or 9/10 HLA-matched unrelated allo-HCT between 2004 and 2015 at EBMT-affiliated transplant centers. The researchers were interested in this topic based on data showing that in patients with minimal residual disease at transplant, “CBT did at least as good as unrelated donor transplantation.”

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Multivariate analysis showed that in comparison to CBT, 10/10 HLA-matched unrelated allo-HCT resulted in a lower incidence of relapse (hazard ration [HR], 0.7; P =.001), a lower incidence of nonrelapse mortality (HR, 0.6; P <.001), significantly better graft-versus-host disease–free and leukemia-free survival (HR, 0.7; P <.001), and better survival (HR, 0.7; P <.001).

Additionally, those patients who were only able to have 9/10 HLA-matched unrelated allo-HCT had significantly improved rates of relapse, nonrelapse mortality, and survival compared with cord blood transplantation.

“These data suggest that in AML patients with active disease at transplantation, allo-HCT with unrelated donors results in better transplantation outcomes that cord blood transplant,” the researchers concluded.

Reference

  1. Baron F, Labopin M, Ruggeri A, et al. Umbilical cord blood versus unrelated donor transplantation in adults with primary refractory or relapsed acute myeloid leukemia: a report from Eurocord, the Acute Leukemia Working Party and the Cord Blood Committee of the Cellular Therapy and Immunobiology Working Party of the EBMT. Blood Cancer J. 2019;9(4):46. doi: 10.1038/s41408-019-0204-x