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- Title
Comparison of umbilical cord blood allogeneic stem cell transplantation vs. auto- SCT for adult acute myeloid leukemia patients in second complete remission at transplant: a retrospective study on behalf of the SFGM- TC.
- Authors
Chevallier, Patrice; Labopin, Myriam; Socie, Gerard; Rubio, Marie‐There; Blaise, Didier; Vigouroux, Stephane; Huynh, Anne; Michallet, Mauricette; Bay, Jacques‐Olivier; Maury, Sébastien; Yakoub‐Agha, Ibrahim; Fegueux, Nathalie; Deconinck, Eric; Contentin, Nathalie; Maillard, Natacha; Bulabois, Claude‐Eric; Francois, Sylvie; Oumedaly, Reman; Raus, Nicole; Mohty, Mohamad
- Abstract
This retrospective study considered the outcomes of 181 patients with acute myeloid leukemia ( AML) transplanted in second complete remission ( CR2) between January 2005 and April 2012 and who received either a myeloablative autologous stem cell transplant (Auto- SCT; n = 82; median age: 48 years; median follow-up: 45 months) or an umbilical cord blood ( UCB) allogeneic SCT ( n = 99, median age: 46 years; median follow-up: 36 months; conditioning regimens: myeloablative n = 21, reduced n = 78; single unit n = 37, double units n = 62). Although the Auto group showed a significant better prognostic profile at transplant, with longer median interval between diagnosis and time of graft, higher incidence of good-risk cytogenetics and lower number of previously transplanted patients, 3-year OS and LFS were similar between both groups (Auto: 59 ± 6% vs. 50 ± 6%, P = 0.45; and 57 ± 6% vs. 46 ± 6%, P = 0.37). In multivariate analysis, UCB allo- SCT was associated with lower relapse incidence ( HR: 0.3, 95% CI: 0.11-0.82, P = 0.02), but higher non-relapse mortality ( NRM) ( HR: 4.16; 95% CI: 1.46-11.9, P = 0.008). Results from this large study suggest that UCB allo- SCT provides better disease control than auto- SCT, which is especially important in the setting of high-risk disease. However, this disease control advantage is counterbalanced by higher toxicity, highlighting the need for novel approaches aiming to decrease NRM after UCB allo- SCT.
- Subjects
ACUTE myeloid leukemia; CYTOGENETICS; STEM cells; MULTIVARIATE analysis; HOMOGRAFTS
- Publication
European Journal of Haematology, 2015, Vol 94, Issue 5, p449
- ISSN
0902-4441
- Publication type
Article
- DOI
10.1111/ejh.12451