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

Frédéric Baron, Myriam Labopin, Annalisa Ruggeri, Gerhard Ehninger, Fransesca Bonifazi, Matthias Stelljes, Jaime Sanz, Gernot Stuhler, Alberto Bosi, Nicolaus Kröger, Maria Teresa Van Lint, Arnold Ganser, Edouard Forcade, Mohamad Mohty, Eliane Gluckman, Arnon Nagler

Research output: Contribution to journalArticle

Abstract

The role of umbilical cord blood transplantation (CBT) in acute myeloid leukemia (AML) patients with active disease at allogeneic hematopoietic cell transplantation (allo-HCT) remains poorly investigated. In this study, we compared transplantation outcomes of 2963 patients with primary refractory or relapsed AML given CBT, 10/10 HLA-matched UD, or 9/10 HLA-matched UD allo-HCT from 2004 to 2015 at EBMT-affiliated centers. Neutrophil engraftment and complete remission rates in CBT, UD 10/10, and UD 9/10 recipients were 75 and 48%, 93 and 69%, and 93 and 70%, respectively. In multivariate Cox analyses, in comparison with CBT (n = 285), UD 10/10 recipients (n = 2001) had a lower incidence of relapse (HR = 0.7, P = 0.001), a lower incidence of non relapse mortality (HR = 0.6, P < 0.001), better GVHD-free and leukemia-free survival (GRFS, HR = 0.8, P < 0.001) and better survival (HR = 0.6, P < 0.001). Further, in comparison with CBT, 9/10 UD recipients (n = 677) also had a lower incidence of relapse (HR = 0.8, P = 0.02), a lower incidence of nonrelapse mortality (HR = 0.7, P = 0.008), better GRFS (HR = 0.8, P = 0.01) and better survival (HR = 0.7, P < 0.001). In summary, these data suggest that in AML patients with active disease at transplantation, allo-HCT with UD results in better transplantation outcomes than CBT.

Original languageEnglish
Pages (from-to)46
JournalBlood Cancer Journal
Volume9
Issue number4
DOIs
Publication statusPublished - Apr 12 2019

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Unrelated Donors
Fetal Blood
Acute Myeloid Leukemia
Leukemia
Transplantation
Cell Transplantation
Incidence
Therapeutics
Recurrence
Survival
Mortality
Homologous Transplantation
Neutrophils
Multivariate Analysis

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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. / Baron, Frédéric; Labopin, Myriam; Ruggeri, Annalisa; Ehninger, Gerhard; Bonifazi, Fransesca; Stelljes, Matthias; Sanz, Jaime; Stuhler, Gernot; Bosi, Alberto; Kröger, Nicolaus; Van Lint, Maria Teresa; Ganser, Arnold; Forcade, Edouard; Mohty, Mohamad; Gluckman, Eliane; Nagler, Arnon.

In: Blood Cancer Journal, Vol. 9, No. 4, 12.04.2019, p. 46.

Research output: Contribution to journalArticle

Baron, Frédéric ; Labopin, Myriam ; Ruggeri, Annalisa ; Ehninger, Gerhard ; Bonifazi, Fransesca ; Stelljes, Matthias ; Sanz, Jaime ; Stuhler, Gernot ; Bosi, Alberto ; Kröger, Nicolaus ; Van Lint, Maria Teresa ; Ganser, Arnold ; Forcade, Edouard ; Mohty, Mohamad ; Gluckman, Eliane ; Nagler, Arnon. / 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. In: Blood Cancer Journal. 2019 ; Vol. 9, No. 4. pp. 46.
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abstract = "The role of umbilical cord blood transplantation (CBT) in acute myeloid leukemia (AML) patients with active disease at allogeneic hematopoietic cell transplantation (allo-HCT) remains poorly investigated. In this study, we compared transplantation outcomes of 2963 patients with primary refractory or relapsed AML given CBT, 10/10 HLA-matched UD, or 9/10 HLA-matched UD allo-HCT from 2004 to 2015 at EBMT-affiliated centers. Neutrophil engraftment and complete remission rates in CBT, UD 10/10, and UD 9/10 recipients were 75 and 48{\%}, 93 and 69{\%}, and 93 and 70{\%}, respectively. In multivariate Cox analyses, in comparison with CBT (n = 285), UD 10/10 recipients (n = 2001) had a lower incidence of relapse (HR = 0.7, P = 0.001), a lower incidence of non relapse mortality (HR = 0.6, P < 0.001), better GVHD-free and leukemia-free survival (GRFS, HR = 0.8, P < 0.001) and better survival (HR = 0.6, P < 0.001). Further, in comparison with CBT, 9/10 UD recipients (n = 677) also had a lower incidence of relapse (HR = 0.8, P = 0.02), a lower incidence of nonrelapse mortality (HR = 0.7, P = 0.008), better GRFS (HR = 0.8, P = 0.01) and better survival (HR = 0.7, P < 0.001). In summary, these data suggest that in AML patients with active disease at transplantation, allo-HCT with UD results in better transplantation outcomes than CBT.",
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T1 - Umbilical cord blood versus unrelated donor transplantation in adults with primary refractory or relapsed acute myeloid leukemia

T2 - 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

AU - Baron, Frédéric

AU - Labopin, Myriam

AU - Ruggeri, Annalisa

AU - Ehninger, Gerhard

AU - Bonifazi, Fransesca

AU - Stelljes, Matthias

AU - Sanz, Jaime

AU - Stuhler, Gernot

AU - Bosi, Alberto

AU - Kröger, Nicolaus

AU - Van Lint, Maria Teresa

AU - Ganser, Arnold

AU - Forcade, Edouard

AU - Mohty, Mohamad

AU - Gluckman, Eliane

AU - Nagler, Arnon

PY - 2019/4/12

Y1 - 2019/4/12

N2 - The role of umbilical cord blood transplantation (CBT) in acute myeloid leukemia (AML) patients with active disease at allogeneic hematopoietic cell transplantation (allo-HCT) remains poorly investigated. In this study, we compared transplantation outcomes of 2963 patients with primary refractory or relapsed AML given CBT, 10/10 HLA-matched UD, or 9/10 HLA-matched UD allo-HCT from 2004 to 2015 at EBMT-affiliated centers. Neutrophil engraftment and complete remission rates in CBT, UD 10/10, and UD 9/10 recipients were 75 and 48%, 93 and 69%, and 93 and 70%, respectively. In multivariate Cox analyses, in comparison with CBT (n = 285), UD 10/10 recipients (n = 2001) had a lower incidence of relapse (HR = 0.7, P = 0.001), a lower incidence of non relapse mortality (HR = 0.6, P < 0.001), better GVHD-free and leukemia-free survival (GRFS, HR = 0.8, P < 0.001) and better survival (HR = 0.6, P < 0.001). Further, in comparison with CBT, 9/10 UD recipients (n = 677) also had a lower incidence of relapse (HR = 0.8, P = 0.02), a lower incidence of nonrelapse mortality (HR = 0.7, P = 0.008), better GRFS (HR = 0.8, P = 0.01) and better survival (HR = 0.7, P < 0.001). In summary, these data suggest that in AML patients with active disease at transplantation, allo-HCT with UD results in better transplantation outcomes than CBT.

AB - The role of umbilical cord blood transplantation (CBT) in acute myeloid leukemia (AML) patients with active disease at allogeneic hematopoietic cell transplantation (allo-HCT) remains poorly investigated. In this study, we compared transplantation outcomes of 2963 patients with primary refractory or relapsed AML given CBT, 10/10 HLA-matched UD, or 9/10 HLA-matched UD allo-HCT from 2004 to 2015 at EBMT-affiliated centers. Neutrophil engraftment and complete remission rates in CBT, UD 10/10, and UD 9/10 recipients were 75 and 48%, 93 and 69%, and 93 and 70%, respectively. In multivariate Cox analyses, in comparison with CBT (n = 285), UD 10/10 recipients (n = 2001) had a lower incidence of relapse (HR = 0.7, P = 0.001), a lower incidence of non relapse mortality (HR = 0.6, P < 0.001), better GVHD-free and leukemia-free survival (GRFS, HR = 0.8, P < 0.001) and better survival (HR = 0.6, P < 0.001). Further, in comparison with CBT, 9/10 UD recipients (n = 677) also had a lower incidence of relapse (HR = 0.8, P = 0.02), a lower incidence of nonrelapse mortality (HR = 0.7, P = 0.008), better GRFS (HR = 0.8, P = 0.01) and better survival (HR = 0.7, P < 0.001). In summary, these data suggest that in AML patients with active disease at transplantation, allo-HCT with UD results in better transplantation outcomes than CBT.

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DO - 10.1038/s41408-019-0204-x

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JO - Blood Cancer Journal

JF - Blood Cancer Journal

SN - 2044-5385

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