Cord blood transplantation for AML: Comparable LFS in patients with de novo versus secondary AML in CR1, an ALWP/EBMT study

Br J Haematol. 2024 Jan;204(1):250-259. doi: 10.1111/bjh.19130. Epub 2023 Oct 2.

Abstract

We investigated whether secondary versus de novo acute myeloid leukaemia (AML) would be associated with poor outcomes in adult acute AML patients in first complete remission (CR1) receiving unrelated cord blood transplantation (CBT). This is a retrospective study from the acute leukaemia working party of the European Society for Blood and Marrow Transplantation. Inclusion criteria included adult at first allogeneic haematopoietic cell transplantation between 2000 and 2021, unrelated single or double unit CBT, AML in CR1, no ex vivo T-cell depletion and no post-transplant cyclophosphamide. The primary end-point of the study was leukaemia-free survival (LFS). A total of 879 patients with de novo (n = 696) or secondary (n = 183) AML met the inclusion criteria. In multivariable analyses, sAML patients had non-significantly different LFS (HR = 0.98, p = 0.86), overall survival (HR = 1.07, p = 0.58), relapse incidence (HR = 0.74, p = 0.09) and non-relapse mortality (HR = 1.26, p = 0.13) than those with de novo AML. Our results demonstrate non-significantly different LFS following CBT in adult patients with secondary versus de novo AML.

Keywords: AML; acute myeloid leukaemia; cord blood transplantation; de novo; secondary.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cord Blood Stem Cell Transplantation* / adverse effects
  • Graft vs Host Disease* / etiology
  • Hematopoietic Stem Cell Transplantation* / methods
  • Humans
  • Leukemia, Myeloid, Acute* / complications
  • Neoplasm Recurrence, Local / etiology
  • Neoplasms, Second Primary* / etiology
  • Receptors, Complement 3b
  • Retrospective Studies
  • Transplantation Conditioning / methods

Substances

  • CR1 protein, human
  • Receptors, Complement 3b