Cord blood transplantation boosts survival in acute myeloid leukaemia

A single cord blood transplantation (CBT) confers improved overall survival (OS) in adult patients with acute myeloid leukaemia (AML), a recent study has found.

Researchers conducted a retrospective assessment of 5,504 AML patients (median age 54 years, 57.7 percent men) who had received a single unit of CBT. Two-year OS outcomes were calculated and compared across three different time periods: 1998–2007 (n=1,029) vs 2008–2003 (n=1,867) vs 2014–2019 (n=2,608).

Overall, the probability of 2-year OS was 44.5 percent. Unadjusted analysis found that 2-year OS improved significantly with time (log-rank p<0.001).

Multivariate analysis confirmed these findings and revealed that mortality was significantly lower during 2008–2013 (hazard ratio [HR], 0.78; p=0.001) and 2014–2019 (HR, 0.63; p<0.001) than during 1998–2007. Other notable factors that significantly affected 2-year OS included age ≥55 years (HR, 1.43; p<0.001), an adverse cytogenetic risk (HR, 1.52; p<0.001), and an advanced disease phase at CBT (HR, 2.22; p<0.001).

A similar trend was reported for relapse-related mortality, which had an overall 2-year rate of 29.8 percent. Multivariate analysis revealed that such an outcome was significantly lowered during 2014–2019 vs 1998–2007 (HR, 0.79; p=0.036). The same was true for non-relapse mortality (2014–2019 vs 1999–2007: HR, 0.71; p=0.003).

“In summary, our registry-based study under real-world settings demonstrated that the survival and engraftment rate after CBT for adult patients with AML has improved over the past 22 years,” the researchers said. “However, mortality after CBT still has room for further improvement.

“Therefore, our real-world experience can support the next major approaches to reduce mortality after CBT for adult patients with AML,” they added.