• Eur. J. Haematol. · May 2015

    Multicenter Study Comparative Study

    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.

    • Patrice Chevallier, Myriam Labopin, Gerard Socie, Marie-There Rubio, Didier Blaise, Stephane Vigouroux, Anne Huynh, Mauricette Michallet, Jacques-Olivier Bay, Sébastien Maury, Ibrahim Yakoub-Agha, Nathalie Fegueux, Eric Deconinck, Nathalie Contentin, Natacha Maillard, Claude-Eric Bulabois, Sylvie Francois, Reman Oumedaly, Nicole Raus, and Mohamad Mohty.
    • Centre Hospitalier et Universitaire (CHU) de Nantes, Hématologie Clinique, Centre d'Investigation Clinique en Cancérologie (CI2C), Université de Nantes and INSERM CRNCA UMR 892, Nantes, France.
    • Eur. J. Haematol. 2015 May 1; 94 (5): 449-55.

    AbstractThis 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.© 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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