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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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.
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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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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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DOI: https://doi.org/10.1038/s41409-022-01742-2