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Outcome of human umbilical cord blood stem cell transplantation (CBT) for acute myeloid leukemia in patients achieving first complete remission after one versus two induction courses: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT)

Bone Marrow Transplantation volume 57, pages 1514–1519 (2022)Cite this article

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Abstract

We compared transplantation outcomes of adult patients with AML that underwent cord blood transplantation (CBT) in CR1 following 1 versus 2 induction courses. Study included 325 patients, 243 (75%) with 1 and 82 (25%) with 2 induction courses. Engraftment was lower for patients achieving CR1 after 1 vs. 2 induction courses: 91% vs. 99% (p = 0.02). Incidence of acute GVHD was similar, 38% and 36% (p = 0.81), as was 2-year chronic GVHD at 23.4% and 27.5%, respectively (p = 0.65). Two-year non-relapse mortality (NRM), relapse incidence (RI), leukemia-free survival (LFS), overall survival (OS) and GVHD-free, relapse-free survival (GRFS) were not statistically different between patients achieving CR1 with 1 vs. 2 induction courses with 23% vs. 24% (p = 0.87), 25% vs. 30% (p = 0.4), 52% vs. 46% (p = 0.3), 59% vs. 50% (p = 0.2), and 44% vs. 41% (p = 0.66), respectively. Results were confirmed by multivariable analysis, NRM (hazard ratio (HR) = 1.1; 95% CI, 0.6–1.8, p = 0.7), RI (HR = 1.4; 95% CI, 0.9–2.3, p = 0.1), LFS (HR = 1.3; 95% CI, 0.9–1.8, p = 0.2), OS (HR = 1.3; 95% CI, 0.9–1.9, p = 0.1), and GRFS (HR = 1.1; 95% CI, 0.8–1.5, p = 0.5). Overall, outcomes of AML patients undergoing CBT in CR1 achieved after 1 or 2 induction courses are similar.

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Fig. 1: Transplantation outcome of human umbilical cord blood stem cell transplantation (CBT) for patients with acute myeloid leukemia achieving first complete remission after one versus two induction courses.

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Data availability

AN, ML, and MM had full access to all study data (available upon data-specific request).

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Acknowledgements

We thank all the EBMT centers and national registries for contributing patients to this study (Supplementary Appendix material). We also thank the data managers for their excellent work.

Author information

Authors and Affiliations

  1. Division of Hematology, Sheba Medical Center, Tel Hashomer, Israel

    Arnon Nagler

  2. EBMT Paris study office; Department of Hematology, Saint Antoine Hospital, Sorbonne University, INSERM UMR 938, Paris, France

    Myriam Labopin

  3. Sorbonne University, Department of Hematology, Saint Antoine Hospital, INSERM UMR 938, Paris, France

    Myriam Labopin

  4. Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Hematology, Rotterdam, the Netherlands

    Jan J. Cornelissen

  5. CHU Bordeaux, Hôpital Haut-Leveque, Pessac, France

    Edouard Forcade

  6. CHU Nantes Department, D’Hematologie, Nantes, France

    Patrice Chevallier

  7. CHU Lapeyronie, Département d’Hématologie Clinique, Montpellier, France

    Nathalie Fegueux

  8. Hospital Santa Creu i Sant Pau Hematology Department, Barcelona, Spain

    Jorge Sierra

  9. Hopital La Miletrie, Head of the Bone Marrow Transplant Unit, Clinical Hematology, Poitiers, France

    Deborah Desmier

  10. Centre Hospitalier Lyon Sud, Pavillon Marcel Bérard, Service Hematologie, Lyon, France

    Hélène Labussière-Wallet

  11. Nottingham University, Nottingham, UK

    Jenny L. Byrne

  12. Cote d’Azur University, Hematology department, Nice University Hospital, Nice, France

    Michael Loschi

  13. Programme de Transplantation & Therapie Cellulaire; Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France

    Didier Blaise

  14. GIGA-I3, University and CHU of Liège, Liège, Belgium

    Frederic Baron

  15. Department of Pediatric Hematology and Oncology, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy

    Annalisa Ruggeri

  16. Department of Hematology, Hospital Saint Antoine, EBMT Paris Study Office/CEREST-TC, Saint Antoine Hospital, Paris, France

    Mohamad Mohty

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Contributions

AN wrote the manuscript, designed the study, and interpreted the data. ML designed the study, performed the statistical analyses, interpreted the data, and edited the manuscript. MM, ML, AR, and FB designed the study, interpreted the data, and edited the manuscript. JJC, EF, PC, NF, JS, DD, HLW, JLB, AN and DB reviewed the manuscript and provided clinical data. All authors approved the final version of the manuscript.

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Correspondence to Arnon Nagler.

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The authors declare no competing interests.

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The scientific boards of the ALWP of the EBMT approved this study.

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Nagler, A., Labopin, M., Cornelissen, J.J. et al. Outcome of human umbilical cord blood stem cell transplantation (CBT) for acute myeloid leukemia in patients achieving first complete remission after one versus two induction courses: a study from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT). Bone Marrow Transplant 57, 1514–1519 (2022). https://doi.org/10.1038/s41409-022-01742-2

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