Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 May 25;12(5):81.
doi: 10.1038/s41408-022-00678-6.

Improved trends in survival and engraftment after single cord blood transplantation for adult acute myeloid leukemia

Takaaki Konuma  1 , Shohei Mizuno  2 , Tadakazu Kondo  3 , Yasuyuki Arai  3 , Naoyuki Uchida  4 , Satoshi Takahashi  5 , Masatsugu Tanaka  6 , Takuro Kuriyama  7 , Shigesaburo Miyakoshi  8 , Makoto Onizuka  9 , Shuichi Ota  10 , Yasuhiro Sugio  11 , Yasushi Kouzai  12 , Toshiro Kawakita  13 , Hikaru Kobayashi  14 , Yukiyasu Ozawa  15 , Takafumi Kimura  16 , Tatsuo Ichinohe  17 , Yoshiko Atsuta  18   19 , Masamitsu Yanada  20 ; Adult Acute Myeloid Leukemia Working Group of the Japanese Society for Transplantation and Cellular Therapy
Affiliations

Improved trends in survival and engraftment after single cord blood transplantation for adult acute myeloid leukemia

Takaaki Konuma et al. Blood Cancer J. .

Abstract

Unrelated cord blood transplantation (CBT) is an alternative curative option for adult patients with acute myeloid leukemia (AML) who need allogeneic hematopoietic cell transplantation (HCT) but lack an HLA-matched related or unrelated donor. However, large-scale data are lacking on CBT outcomes for unselected adult AML. To investigate the trends of survival and engraftment after CBT over the past 22 years, we retrospectively evaluated the data of patients with AML in Japan according to the time period of CBT (1998-2007 vs 2008-2013 vs 2014-2019). A total of 5504 patients who received single-unit CBT as first allogeneic HCT for AML were included. Overall survival (OS) at 2 years significantly improved over time. The improved OS among patients in ≥ complete remission (CR)3 and active disease at CBT was mainly due to a reduction of relapse-related mortality, whereas among patients in first or second CR at CBT, this was due mainly to a reduction of non-relapse mortality. The trends of neutrophil engraftment also improved over time. This experience demonstrated that the survival and engraftment rate after CBT for this group has improved over the past 22 years.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Overall survival, relapse-related moratlity, and non-relapse mortality after CBT in the entire cohort.
The probability of overall survival (A) and the cumulative incidences of relapse-related mortality (B) and non-relapse mortality (C) after CBT according to the three time periods in the entire cohort. Forest plots of the adjusted hazard ratios (HR) and 95% confidence intervals (CI) of overall mortality, relapse-related mortality, and non-relapse mortality in the multivariate analysis (D).
Fig. 2
Fig. 2. Overall survival after CBT according to disease status at CBT.
The probabilities of overall survival after CBT according to the three time periods in patients with early phase at CBT (A), or advanced phase at CBT (B). Forest plots of the adjusted hazard ratios (HR) and 95% confidence intervals (CI) of overall mortality among each cohort in the multivariate analysis (C).
Fig. 3
Fig. 3. Relapse-related mortality after CBT according to disease status at CBT.
The cumulative incidences of relapse-related mortality after CBT according to the three time periods in patients with early phase at CBT (A), or advanced phase at CBT (B). Forest plots for the adjusted hazard ratios (HR) and 95% confidence intervals (CI) of relapse-related mortality among each cohort in the multivariate analysis (C).
Fig. 4
Fig. 4. Non-relapse mortality after CBT according to disease status at CBT.
The cumulative incidences of non-relapse mortality after CBT according to the three time periods in patients with early phase at CBT (A), or advanced phase at CBT (B). Forest plots of the adjusted hazard ratios (HR) and 95% confidence intervals (CI) of non-relapse mortality among each cohort in the multivariate analysis (C).
Fig. 5
Fig. 5. Neutrophil engraftment after CBT according to disease status at CBT.
The cumulative incidences of neutrophil engraftment after CBT according to the three time periods in patients with early phase at CBT (A), or advanced phase at CBT (B). Forest plots of the adjusted hazard ratios (HR) and 95% confidence intervals (CI) of neutrophil engraftment among each cohort in the multivariate analysis (C).
See this image and copyright information in PMC

References

    1. Rocha V, Gluckman E, Eurocord-Netcord registry and European Blood and Marrow Transplant group. Improving outcomes of cord blood transplantation: HLA matching, cell dose and other graft- and transplantation-related factors. Br J Haematol. 2009;147:262–74. doi: 10.1111/j.1365-2141.2009.07883.x. - DOI - PubMed
    1. Ballen KK, Gluckman E, Broxmeyer HE. Umbilical cord blood transplantation: the first 25 years and beyond. Blood. 2013;122:491–8. doi: 10.1182/blood-2013-02-453175. - DOI - PMC - PubMed
    1. Yamamoto H. Single cord blood transplantation in Japan; expanding the possibilities of CBT. Int J Hematol. 2019;110:39–49. doi: 10.1007/s12185-019-02672-4. - DOI - PubMed
    1. Eapen M, Rocha V, Sanz G, Scaradavou A, Zhang MJ, Arcese W, et al. Effect of graft source on unrelated donor haemopoietic stem-cell transplantation in adults with acute leukaemia: a retrospective analysis. Lancet Oncol. 2010;11:653–60. doi: 10.1016/S1470-2045(10)70127-3. - DOI - PMC - PubMed
    1. Milano F, Gooley T, Wood B, Woolfrey A, Flowers ME, Doney K, et al. Cord-Blood Transplantation in Patients with Minimal Residual Disease. N. Engl J Med. 2016;375:944–53. doi: 10.1056/NEJMoa1602074. - DOI - PMC - PubMed

Publication types